Provider Demographics
NPI:1033172028
Name:ANDRES, HOLLY ADELE (MSW)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:ADELE
Last Name:ANDRES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 W LAKE MEAD BLVD
Mailing Address - Street 2:SUITE 9-472
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0297
Mailing Address - Country:US
Mailing Address - Phone:702-810-4122
Mailing Address - Fax:702-240-1625
Practice Address - Street 1:2441 TECH CENTER CT
Practice Address - Street 2:SUITE 109
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0804
Practice Address - Country:US
Practice Address - Phone:702-810-4122
Practice Address - Fax:702-240-1625
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4097-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical