Provider Demographics
NPI:1619183779
Name:HOLLAND, JOAN P (MSSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:P
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:MSSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 LBJ FWY
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7770
Mailing Address - Country:US
Mailing Address - Phone:972-841-8472
Mailing Address - Fax:972-243-2534
Practice Address - Street 1:3010 LBJ FWY.
Practice Address - Street 2:SUITE 1200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7770
Practice Address - Country:US
Practice Address - Phone:972-919-6159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX048831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX04883OtherLCSW STATE LICENSE NUMBER