MEDICARE: MRS. EMMY CLARK HOLLOMAN M.S., CRC, LCAS-P

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAS-2462	NC
2	101YM0800X	Mental Health Counselor	11831	NC

General Provider Information

NPI Number	:	1518259894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMMY CLARK HOLLOMAN M.S., CRC, LCAS-P

Provider Business Mailing Address
First Line	:	1700 JONES SMITH RD
Second Line	:
City	:	KINSTON
State	:	NC
Zip	:	28501-9103
Country	:	US
Telephone Number	:	336-964-0082
Fax Number	:

Provider Business Practice Location Address
First Line	:	6026 SIX FORKS RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-3899
Country	:	US
Telephone Number	:	919-865-8710
Fax Number	:	919-977-9760

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

Provider Enumeration Date	:	05/05/2011
Last Update Date	:	02/22/2022

Similar Medicare Providers

1396609293 — TRACEY MONIQUE CHANCE RN
Practice Location Address:

6026 SIX FORKS RD
RALEIGH, NC
27609-3899

Practice Phone: 919-758-8014
Practice Fax:

1982940904 — MS. KELLY REBECCA MCCONKEY MA, LPC, NCC
Practice Location Address:

6026 SIX FORKS RD
RALEIGH, NC
27609-3899

Practice Phone: 919-848-0132
Practice Fax: 919-848-0277

1902340862 — MS. MARISA DANIELLE SMITH PA
Practice Location Address:

6026 SIX FORKS RD
RALEIGH, NC
27609-3899

Practice Phone: 919-848-0132
Practice Fax: 919-848-0277

1821554239 — CLARISSA A RIGGLEMAN MS, BCBA
Practice Location Address:

6036 SIX FORKS RD STE 6020
RALEIGH, NC
27609-3899

Practice Phone: 855-772-8847
Practice Fax:

1184268260 — JESSICA HAMILTON BCBA, MA
Practice Location Address:

6036 SIX FORKS RD STE 6020
RALEIGH, NC
27609-3899

Practice Phone: 855-772-8847
Practice Fax:

1659985984 — ISABELLA ROSALIE CINA BCBA
Practice Location Address:

6036 SIX FORKS RD STE 6020
RALEIGH, NC
27609-3899

Practice Phone: 855-772-8847
Practice Fax:

Directions to “ MRS. EMMY CLARK HOLLOMAN M.S., CRC, LCAS-P” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.