Provider Demographics
NPI:1952466856
Name:HOLLAWAY, DEANA MICHELLE (PHD, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:DEANA
Middle Name:MICHELLE
Last Name:HOLLAWAY
Suffix:
Gender:F
Credentials:PHD, NCC, LPC
Other - Prefix:
Other - First Name:DEANA
Other - Middle Name:HOLLAWAY
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LPC-S, BCTMH
Mailing Address - Street 1:15009 COLLIER DR SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-3689
Mailing Address - Country:US
Mailing Address - Phone:256-777-1870
Mailing Address - Fax:
Practice Address - Street 1:4800 WHITESPORT CIR SW STE 2
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6443
Practice Address - Country:US
Practice Address - Phone:256-533-9393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1417101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-37349OtherBLUECROSS BLUESHIELD