Provider Demographics
NPI:1578812392
Name:HOLLIFIELD, MEGHAN RAE (LCSWA, LCASA)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:RAE
Last Name:HOLLIFIELD
Suffix:
Gender:F
Credentials:LCSWA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WHITSON RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-9191
Mailing Address - Country:US
Mailing Address - Phone:828-442-1820
Mailing Address - Fax:828-627-1307
Practice Address - Street 1:33 SHARON LYNNE WAY
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8285
Practice Address - Country:US
Practice Address - Phone:828-452-1300
Practice Address - Fax:828-627-1307
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NCP0074801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)