MEDICARE: MRS. HOLLY KATHRYN MANN LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH27460	FL

General Provider Information

NPI Number	:	1306788633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HOLLY KATHRYN MANN LMHC

Provider Business Mailing Address
First Line	:	2031 BRISSON AVE
Second Line	:
City	:	SANFORD
State	:	FL
Zip	:	32771-8464
Country	:	US
Telephone Number	:	618-559-0750
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 TOWN PLAZA CT STE D
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-6231
Country	:	US
Telephone Number	:	618-559-0750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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