Provider Demographics
NPI:1871655803
Name:HOLLIER, DWIGHT (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:DWIGHT
Middle Name:
Last Name:HOLLIER
Suffix:
Gender:M
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 NORTH TRYON STREET
Mailing Address - Street 2:SUITE 309
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206
Mailing Address - Country:US
Mailing Address - Phone:704-940-1280
Mailing Address - Fax:704-940-1281
Practice Address - Street 1:1801 NORTH TRYON STREET
Practice Address - Street 2:SUITE 309
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206
Practice Address - Country:US
Practice Address - Phone:704-940-1280
Practice Address - Fax:704-940-1281
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5312101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC225560OtherNCC
NC6103517Medicaid
NC5312OtherLPC NUMBER