Provider Demographics
NPI:1477888741
Name:HOLLAND, MICHAEL WILLIAM (PHD, LPC, LADAC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:PHD, LPC, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 E. SUNBRIDGE DR.
Mailing Address - Street 2:65 E. SUNBRIDGE DR.
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2894
Mailing Address - Country:US
Mailing Address - Phone:479-443-9707
Mailing Address - Fax:479-443-4505
Practice Address - Street 1:65 E. SUNBRIDGE DR.
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2894
Practice Address - Country:US
Practice Address - Phone:479-443-9707
Practice Address - Fax:479-443-4505
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR0264L101YA0400X
ARP0710061101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)