Provider Demographics
NPI:1275918633
Name:STEWARD, HOLLY (MED, LPC)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:STEWARD
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2524 LILLIAN MILLER PKWY
Practice Address - Street 2:SUITE 115
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-7206
Practice Address - Country:US
Practice Address - Phone:817-381-8752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70411101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional