Provider Demographics
NPI:1518325844
Name:HOLSCLAW, PATRICIA (MA, LPC, ATR)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:HOLSCLAW
Suffix:
Gender:F
Credentials:MA, LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4045 FOREST OAKS LN
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-9613
Mailing Address - Country:US
Mailing Address - Phone:919-563-4628
Mailing Address - Fax:
Practice Address - Street 1:4045 FOREST OAKS LN
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-9613
Practice Address - Country:US
Practice Address - Phone:919-563-4628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8794101YP2500X
NC94-083221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist