Provider Demographics
NPI:1376946251
Name:HOLLY MAY, PH.D., LLC
Entity Type:Organization
Organization Name:HOLLY MAY, PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:970-381-9775
Mailing Address - Street 1:1304 40TH AVE
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2704
Mailing Address - Country:US
Mailing Address - Phone:970-301-4775
Mailing Address - Fax:
Practice Address - Street 1:1610 29TH AVENUE PL
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-6813
Practice Address - Country:US
Practice Address - Phone:970-221-0665
Practice Address - Fax:970-462-9240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2678103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11151242Medicaid