Provider Demographics
NPI:1023687415
Name:HOOLEY, RAE LYNN (LPC)
Entity type:Individual
Prefix:MRS
First Name:RAE
Middle Name:LYNN
Last Name:HOOLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:RAE
Other - Middle Name:LYNN
Other - Last Name:HELTERBRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:607 HERITAGE CT
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-5471
Mailing Address - Country:US
Mailing Address - Phone:616-396-6285
Mailing Address - Fax:616-396-6172
Practice Address - Street 1:607 HERITAGE CT
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-5471
Practice Address - Country:US
Practice Address - Phone:616-396-6285
Practice Address - Fax:616-396-6172
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2022-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017360101YP2500X
MI6401222733101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional