Provider Demographics
NPI:1407503600
Name:HOLOHAN, REBECCA (LPCC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:HOLOHAN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 RENAISSANCE DR APT H308
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-6989
Mailing Address - Country:US
Mailing Address - Phone:720-381-3046
Mailing Address - Fax:
Practice Address - Street 1:1420 RENAISSANCE DR APT H308
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-6989
Practice Address - Country:US
Practice Address - Phone:720-381-3046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0018581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health