Provider Demographics
NPI:1801853460
Name:HOLZHALB, CAROL MURPHY (PHD, LCSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:MURPHY
Last Name:HOLZHALB
Suffix:
Gender:F
Credentials:PHD, LCSW
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 907217
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-0904
Mailing Address - Country:US
Mailing Address - Phone:770-532-3700
Mailing Address - Fax:770-532-0059
Practice Address - Street 1:100 SPRING ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2565
Practice Address - Country:US
Practice Address - Phone:770-532-3700
Practice Address - Fax:770-532-0059
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0013741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000939111AMedicaid
GA10752575OtherCAQH ID #
GA9166085OtherAPS HEALTHCARE ID#
GAH2080OtherKAISER #
GA007712OtherVALUE OPTIONS PIN#
GA52470975OtherBCBS-GA ID #
GA085070OtherMHN PIN #
GA4278571OtherAETNA ID #
GAS92621Medicare UPIN
GA80BBBQLMedicare ID - Type UnspecifiedMEDICARE IND. PROVIDER #