Provider Demographics
NPI:1346929080
Name:HOLLEY, THORIN QUICKSILVER (LPC)
Entity Type:Individual
Prefix:
First Name:THORIN
Middle Name:QUICKSILVER
Last Name:HOLLEY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3229 CRISPIN HALL LN
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3687
Mailing Address - Country:US
Mailing Address - Phone:785-375-7249
Mailing Address - Fax:
Practice Address - Street 1:3229 CRISPIN HALL LN
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3687
Practice Address - Country:US
Practice Address - Phone:785-375-7249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87107101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health