Provider Demographics
NPI:1467850271
Name:HALL, HOLLYI SUSANNE (EDS LMFT)
Entity Type:Individual
Prefix:MS
First Name:HOLLYI
Middle Name:SUSANNE
Last Name:HALL
Suffix:
Gender:F
Credentials:EDS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 MURFREESBORO PIKE STE 702
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2679
Mailing Address - Country:US
Mailing Address - Phone:844-359-7629
Mailing Address - Fax:615-577-5654
Practice Address - Street 1:17B CALDEDON CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615
Practice Address - Country:US
Practice Address - Phone:864-631-2084
Practice Address - Fax:615-577-5654
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
SC4639106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist