Provider Demographics
NPI:1700207131
Name:HOLIDAY, OLIVIA R (LPCC)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:R
Last Name:HOLIDAY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 AUTUMN HAZE LN
Mailing Address - Street 2:
Mailing Address - City:KENTON
Mailing Address - State:OH
Mailing Address - Zip Code:43326-1449
Mailing Address - Country:US
Mailing Address - Phone:740-350-7275
Mailing Address - Fax:
Practice Address - Street 1:200 HARDING AVE
Practice Address - Street 2:
Practice Address - City:KENTON
Practice Address - State:OH
Practice Address - Zip Code:43326-1669
Practice Address - Country:US
Practice Address - Phone:419-679-5994
Practice Address - Fax:419-225-8878
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1200520101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional