Provider Demographics
NPI:1376886770
Name:KRAHN, HOLLY (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:
Last Name:KRAHN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MS
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:VANDERHEYDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5900 E MAINSGATE RD
Mailing Address - Street 2:APT 705
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67220-2743
Mailing Address - Country:US
Mailing Address - Phone:847-790-6680
Mailing Address - Fax:
Practice Address - Street 1:400 N WOODLAWN ST
Practice Address - Street 2:SUITE 106
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-4338
Practice Address - Country:US
Practice Address - Phone:316-530-1563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC2494101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health