Provider Demographics
NPI:1437122496
Name:HOLLAND, KIMBERLY LYNN (LPC)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:LYNN
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 MEADOW LANE
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24078
Mailing Address - Country:US
Mailing Address - Phone:276-352-5115
Mailing Address - Fax:276-622-2099
Practice Address - Street 1:226 MEADOW LANE
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24078
Practice Address - Country:US
Practice Address - Phone:276-352-5115
Practice Address - Fax:276-622-2099
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002352101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945221Medicaid