Provider Demographics
NPI:1346667896
Name:HOLLY HARMON, LICSW, LLC
Entity Type:Organization
Organization Name:HOLLY HARMON, LICSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-807-4637
Mailing Address - Street 1:800 TURNPIKE ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-6156
Mailing Address - Country:US
Mailing Address - Phone:978-807-4637
Mailing Address - Fax:
Practice Address - Street 1:800 TURNPIKE ST
Practice Address - Street 2:SUITE 300
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-6156
Practice Address - Country:US
Practice Address - Phone:978-807-4637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-22
Last Update Date:2014-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1166041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty