Provider Demographics
NPI:1679011985
Name:HOLLINGSWORTH, WARRENETTA (LPC)
Entity Type:Individual
Prefix:
First Name:WARRENETTA
Middle Name:
Last Name:HOLLINGSWORTH
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 1:645 W NORTHGATE PKWY
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-3321
Mailing Address - Country:US
Mailing Address - Phone:419-467-9423
Mailing Address - Fax:
Practice Address - Street 1:645 W NORTHGATE PKWY
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-3321
Practice Address - Country:US
Practice Address - Phone:419-467-9423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCO900159101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional