Provider Demographics
NPI:1538284138
Name:HOLLADAY & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:HOLLADAY & ASSOCIATES, LLC
Other - Org Name:HOLLADAY & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JANA
Authorized Official - Middle Name:T
Authorized Official - Last Name:MINER-COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:907-745-7080
Mailing Address - Street 1:634 S BAILEY ST STE 207
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-6360
Mailing Address - Country:US
Mailing Address - Phone:907-745-7080
Mailing Address - Fax:907-745-6263
Practice Address - Street 1:634 S BAILEY ST STE 207
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-6360
Practice Address - Country:US
Practice Address - Phone:907-745-7080
Practice Address - Fax:907-745-6263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK86106H00000X
AK77106H00000X
AK24422084P0800X
AK241363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMH9931Medicaid
AKMH9931Medicaid