Provider Demographics
NPI:1639526510
Name:JOHANNA D. VON HOLLINGER, MA, LMFT, LLC
Entity Type:Organization
Organization Name:JOHANNA D. VON HOLLINGER, MA, LMFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOHANNA
Authorized Official - Middle Name:D
Authorized Official - Last Name:VON HOLLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:203-339-1567
Mailing Address - Street 1:57 PLAINS RD
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-2573
Mailing Address - Country:US
Mailing Address - Phone:203-339-1567
Mailing Address - Fax:203-306-3399
Practice Address - Street 1:57 PLAINS RD
Practice Address - Street 2:SUITE 1B
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06461-2573
Practice Address - Country:US
Practice Address - Phone:203-339-1567
Practice Address - Fax:203-306-3399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1065106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty