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NPI Code Detail

MEDICARE: KATHERINE JOHNSON HOLLOWAY LCSW

MEDICARE: KATHERINE JOHNSON HOLLOWAY LCSW
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
11041C0700XClinical Social Worker8173LA

General Provider Information

NPI Number : 1487918058
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE JOHNSON HOLLOWAY LCSW
Provider Business Mailing Address
First Line : 4501 JACKSON STREET EXTENSION
Second Line : SUITE C #256
City : ALEXANDRIA
State : LA
Zip : 71303
Country : US
Telephone Number : 318-625-5971
Fax Number :
Provider Business Practice Location Address
First Line : 109 YORKTOWN DR
Second Line : STE B
City : ALEXANDRIA
State : LA
Zip : 71303-3673
Country : US
Telephone Number : 318-487-9895
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2012
Last Update Date : 01/24/2021

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Directions to “ KATHERINE JOHNSON HOLLOWAY LCSW” Practice Location

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