Provider Demographics
NPI:1033310826
Name:HOLLOWELL, JENNIFER ANN (MA,LPC,CCS,CSAC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANN
Last Name:HOLLOWELL
Suffix:
Gender:F
Credentials:MA,LPC,CCS,CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 CHESTNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-9600
Mailing Address - Country:US
Mailing Address - Phone:828-686-0354
Mailing Address - Fax:828-686-0359
Practice Address - Street 1:65 CHESTNUT HILL RD
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-9600
Practice Address - Country:US
Practice Address - Phone:828-686-0354
Practice Address - Fax:828-686-0359
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-059-035324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility