Provider Demographics
NPI:1396376273
Name:DAHL, HOLLY (MS, LPC, LCDC-INTERN)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:DAHL
Suffix:
Gender:F
Credentials:MS, LPC, LCDC-INTERN
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, LCDC-INTERN
Mailing Address - Street 1:8400 STACY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2144
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:613 W OAK ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009-6381
Practice Address - Country:US
Practice Address - Phone:682-208-7872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78483101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional