Provider Demographics
NPI:1215594635
Name:HOLYOAK, SIMONE YVONNE (LCSW)
Entity Type:Individual
Prefix:
First Name:SIMONE
Middle Name:YVONNE
Last Name:HOLYOAK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SIMONE
Other - Middle Name:YVONNE
Other - Last Name:REGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:152 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:UT
Mailing Address - Zip Code:84320-2009
Mailing Address - Country:US
Mailing Address - Phone:435-523-3718
Mailing Address - Fax:435-375-4269
Practice Address - Street 1:338 W 300 N STE 4
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:UT
Practice Address - Zip Code:84318-4044
Practice Address - Country:US
Practice Address - Phone:435-523-3718
Practice Address - Fax:435-375-4269
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor