Provider Demographics
NPI:1881834000
Name:HOLLINGSWORTH, MARY ANN (LPC NCC, DCC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANN
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:LPC NCC, DCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:MS
Mailing Address - Zip Code:39355-2134
Mailing Address - Country:US
Mailing Address - Phone:601-776-2170
Mailing Address - Fax:601-776-2172
Practice Address - Street 1:109 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:MS
Practice Address - Zip Code:39355-2134
Practice Address - Country:US
Practice Address - Phone:601-776-2170
Practice Address - Fax:601-776-2172
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0843101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional