Provider Demographics
NPI:1023572328
Name:HOLLOWAY, VIRGINIA ANN (PIP, LCSW)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:ANN
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:PIP, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 TWINING ST BLDG MAXWELL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36112-6027
Mailing Address - Country:US
Mailing Address - Phone:335-953-3368
Mailing Address - Fax:334-953-8607
Practice Address - Street 1:300 SOUTH TWINING STREET BUILDING 760
Practice Address - Street 2:
Practice Address - City:MAXWELL
Practice Address - State:AL
Practice Address - Zip Code:36012
Practice Address - Country:US
Practice Address - Phone:334-953-3368
Practice Address - Fax:334-953-8607
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1459-3905C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical