Provider Demographics
NPI:1851914725
Name:HOLLOWAY, CALIE (LICSW)
Entity Type:Individual
Prefix:
First Name:CALIE
Middle Name:
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 10TH PL NW
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35503-6498
Mailing Address - Country:US
Mailing Address - Phone:205-544-4766
Mailing Address - Fax:
Practice Address - Street 1:15 LONGWOOD PL
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35504-7231
Practice Address - Country:US
Practice Address - Phone:205-512-1069
Practice Address - Fax:256-796-7213
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional