Provider Demographics
NPI:1093218414
Name:LOLLEY, MARGARET ROSE (MS, LPC, CCH)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ROSE
Last Name:LOLLEY
Suffix:
Gender:F
Credentials:MS, LPC, CCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HANNON AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-1202
Mailing Address - Country:US
Mailing Address - Phone:251-654-5655
Mailing Address - Fax:
Practice Address - Street 1:1509 GOVERNMENT ST STE 102
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-2016
Practice Address - Country:US
Practice Address - Phone:251-236-7879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3863101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional