Provider Demographics
NPI:1629200605
Name:HOLLEMAN, BRENDA S (LPC)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:S
Last Name:HOLLEMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6005 CRANBERRY DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-3879
Mailing Address - Country:US
Mailing Address - Phone:919-856-2762
Mailing Address - Fax:919-856-2765
Practice Address - Street 1:6005 CRANBERRY DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3879
Practice Address - Country:US
Practice Address - Phone:919-856-2762
Practice Address - Fax:919-856-2765
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7415101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional