Provider Demographics
NPI:1598052003
Name:HOLLADAY-COFFMAN, RACHEL (LPC CRC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HOLLADAY-COFFMAN
Suffix:
Gender:F
Credentials:LPC CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3508 JOHN F KENNEDY BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-8843
Mailing Address - Country:US
Mailing Address - Phone:501-992-7527
Mailing Address - Fax:
Practice Address - Street 1:3508 JOHN F KENNEDY BLVD STE 2
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-8843
Practice Address - Country:US
Practice Address - Phone:501-992-7527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2022-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1809115101YP2500X
ARA1503046101Y00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator