Provider Demographics
NPI:1891068367
Name:BRICE, HOLLI (MSW, LCSW, LSWAIC)
Entity Type:Individual
Prefix:
First Name:HOLLI
Middle Name:
Last Name:BRICE
Suffix:
Gender:F
Credentials:MSW, LCSW, LSWAIC
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 873813
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98687-3813
Mailing Address - Country:US
Mailing Address - Phone:971-231-4046
Mailing Address - Fax:
Practice Address - Street 1:410 E 20TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-3316
Practice Address - Country:US
Practice Address - Phone:971-231-4046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2021-09-07
Deactivation Date:2017-04-13
Deactivation Code:
Reactivation Date:2018-05-31
Provider Licenses
StateLicense IDTaxonomies
ORL107131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty