Provider Demographics
NPI:1457081994
Name:HINTZ, HOLLY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:
Last Name:HINTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3632 LAND O LAKES BLVD STE 105-16
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-4405
Mailing Address - Country:US
Mailing Address - Phone:352-464-3032
Mailing Address - Fax:
Practice Address - Street 1:3632 LAND O LAKES BLVD STE 105-16
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-4405
Practice Address - Country:US
Practice Address - Phone:352-464-3032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical