Provider Demographics
NPI:1184816480
Name:HOLLINGSWORTH, CAMERON LANE (MA)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:LANE
Last Name:HOLLINGSWORTH
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 ADAMS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-1023
Mailing Address - Country:US
Mailing Address - Phone:405-310-3735
Mailing Address - Fax:405-310-3576
Practice Address - Street 1:2911 ADAMS RD STE 101
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-1023
Practice Address - Country:US
Practice Address - Phone:405-310-3735
Practice Address - Fax:405-310-3576
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1017106H00000X
OK4485101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist