Provider Demographics
NPI:1992019012
Name:MATTHEWS, HOLLEY RACHELLE (LPC)
Entity Type:Individual
Prefix:MS
First Name:HOLLEY
Middle Name:RACHELLE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 E 9TH AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3558
Mailing Address - Country:US
Mailing Address - Phone:720-375-4113
Mailing Address - Fax:
Practice Address - Street 1:222 MILWAUKEE ST STE 104
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5009
Practice Address - Country:US
Practice Address - Phone:720-375-4113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5565101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional