Provider Demographics
NPI:1689140329
Name:HOLLOWAY, JANELLE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17800 GRANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2137
Mailing Address - Country:US
Mailing Address - Phone:708-261-8050
Mailing Address - Fax:
Practice Address - Street 1:10046 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-1926
Practice Address - Country:US
Practice Address - Phone:773-981-0565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-21
Last Update Date:2018-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health