Provider Demographics
NPI:1225507346
Name:HOLLEMAN, AUSTYN JORDAN (MSW)
Entity Type:Individual
Prefix:
First Name:AUSTYN
Middle Name:JORDAN
Last Name:HOLLEMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 T ST NW APT 202
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-3934
Mailing Address - Country:US
Mailing Address - Phone:919-215-4089
Mailing Address - Fax:
Practice Address - Street 1:2333 ONTARIO RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2627
Practice Address - Country:US
Practice Address - Phone:202-987-4227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC2000013811041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical