Provider Demographics
NPI:1003808189
Name:KARCHER, HOLLIS KAY (LMSW)
Entity Type:Individual
Prefix:
First Name:HOLLIS
Middle Name:KAY
Last Name:KARCHER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21830 MARTINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-6005
Mailing Address - Country:US
Mailing Address - Phone:712-328-9733
Mailing Address - Fax:
Practice Address - Street 1:HEARTLAND FAMILY SERVICE
Practice Address - Street 2:515 EAST BROADWAY
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503
Practice Address - Country:US
Practice Address - Phone:712-322-1407
Practice Address - Fax:712-322-6833
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IALMSW 06145104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker