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General NPI Number Information
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NPI Number | 1649593401
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Entity Type | Individual
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Provider Name | KATHERINE ANN HOLLEY LMSW, CAADC
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Gender | Female
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 06/14/2018
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Provider Practice Location Address
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Address Line | 420 W 5TH AVE
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City | FLINT
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State | MI
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Zip | 48503
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Country | US
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Telephone | 810-257-3709
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Fax | 810-257-3755
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Provider Business Mailing Address
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Address Line | 402 N LAPEER ST APT 3
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City | DAVISON
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State | MI
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Zip | 48423-1429
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Country | US
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Telephone | 810-347-2330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | C-03057
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801094477
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License Number State | MI
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