Provider Demographics
NPI:1134713001
Name:JAMES HOLLAND JR, LICENSED CLINICAL SOCIAL WORKER INC
Entity type:Organization
Organization Name:JAMES HOLLAND JR, LICENSED CLINICAL SOCIAL WORKER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW, MSW
Authorized Official - Phone:661-264-6428
Mailing Address - Street 1:PO BOX 21662
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-1662
Mailing Address - Country:US
Mailing Address - Phone:661-264-6428
Mailing Address - Fax:844-361-4927
Practice Address - Street 1:4646 WILSON RD STE 200
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-5895
Practice Address - Country:US
Practice Address - Phone:661-264-6428
Practice Address - Fax:844-361-4927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty