Provider Demographics
NPI:1033426515
Name:MILLHOLLON, EDDIE PAUL (PHD, LPC-S)
Entity Type:Individual
Prefix:DR
First Name:EDDIE
Middle Name:PAUL
Last Name:MILLHOLLON
Suffix:
Gender:M
Credentials:PHD, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 JORDAN ST STE 550
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4526
Mailing Address - Country:US
Mailing Address - Phone:318-734-9771
Mailing Address - Fax:318-383-6653
Practice Address - Street 1:820 JORDAN ST STE 550
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4526
Practice Address - Country:US
Practice Address - Phone:318-734-9771
Practice Address - Fax:318-383-6653
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3716101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional