Provider Demographics
NPI:1659322949
Name:COUNTS VANHOOSE, HOLLY R (PSYD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:R
Last Name:COUNTS VANHOOSE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-0015
Mailing Address - Country:US
Mailing Address - Phone:802-359-9139
Mailing Address - Fax:802-359-3468
Practice Address - Street 1:21 PLEASANT ST STE 235
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2623
Practice Address - Country:US
Practice Address - Phone:802-359-9139
Practice Address - Fax:937-359-3468
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2019-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10904103TC0700X
VT048.0106033103TC0700X
OH5320103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1024051Medicaid
VTY100192750Medicare PIN
OHCP21283Medicare ID - Type Unspecified