Provider Demographics
NPI:1083809743
Name:HOLLOWAY, JANINE FLAGG (LMFT, LMHC)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:FLAGG
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:LMFT, LMHC
Other - Prefix:
Other - First Name:JANINE
Other - Middle Name:ALANE
Other - Last Name:FLAGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2208 W DUTCH DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3481
Mailing Address - Country:US
Mailing Address - Phone:469-964-0448
Mailing Address - Fax:469-886-1887
Practice Address - Street 1:2208 W DUTCH DR
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3481
Practice Address - Country:US
Practice Address - Phone:469-964-0448
Practice Address - Fax:469-886-1887
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9955101YM0800X
TXLMFT-202319106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALMFT-1465OtherDIVISION OF PROFESSIONAL LICENSURE, BOARD OF ALLIED HEALTH
FLLMFT-TPMF458OtherFLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE
CALMFT-46740OtherBOARD OF BEHAVIORAL SCIENCES
ARM2202001OtherARKANSAS STATE BOARD OF EXAMINERS IN COUNSELING
TXLMFT-202319OtherTEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL
MALMHC-9955OtherDIVISION OF PROFESSIONAL LICENSURE, BOARD OF ALLIED HEALTH
ARM2202001OtherLICENSED MARRIAGE & FAMILY THERAPIST