Provider Demographics
NPI:1275665333
Name:BEARDEN, HOLLIE J (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:HOLLIE
Middle Name:J
Last Name:BEARDEN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 S KIHEI RD STE 205
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-8145
Mailing Address - Country:US
Mailing Address - Phone:808-868-8074
Mailing Address - Fax:
Practice Address - Street 1:1325 S KIHEI RD STE 205
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8145
Practice Address - Country:US
Practice Address - Phone:808-868-8074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist