Provider Demographics
NPI:1225176597
Name:HOLLIFIELD, TALITHA TAYLOR (LPC LMFT)
Entity Type:Individual
Prefix:MS
First Name:TALITHA
Middle Name:TAYLOR
Last Name:HOLLIFIELD
Suffix:
Gender:F
Credentials:LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1167 SPRATLIN PARK DR
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-6205
Mailing Address - Country:US
Mailing Address - Phone:423-467-3600
Mailing Address - Fax:423-467-3644
Practice Address - Street 1:3169 2ND AVE E
Practice Address - Street 2:
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-3805
Practice Address - Country:US
Practice Address - Phone:276-523-8300
Practice Address - Fax:423-467-3644
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717000341LMFT106H00000X
VA0701002203101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist