Provider Demographics
NPI:1548737901
Name:SMITH, HOLLY WELSH (LICSW)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:WELSH
Last Name:SMITH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:WELSH
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:11 HAWTHORNE RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-4218
Mailing Address - Country:US
Mailing Address - Phone:603-534-4250
Mailing Address - Fax:
Practice Address - Street 1:11 HAWTHORNE RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-4218
Practice Address - Country:US
Practice Address - Phone:603-534-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-24
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1153501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical