Provider Demographics
NPI:1497923452
Name:HOLLEY, SANDRA K (LPC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:K
Last Name:HOLLEY
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 1:1625 K ST NW
Mailing Address - Street 2:SUITE 310
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1604
Mailing Address - Country:US
Mailing Address - Phone:703-929-7000
Mailing Address - Fax:
Practice Address - Street 1:1625 K ST NW
Practice Address - Street 2:SUITE 310
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1604
Practice Address - Country:US
Practice Address - Phone:703-929-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC13889101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health