Provider Demographics
NPI:1245436435
Name:HOLLOWAY, MARCI LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:MARCI
Middle Name:LYNN
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 LEDGEMONT DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3508
Mailing Address - Country:US
Mailing Address - Phone:817-233-7269
Mailing Address - Fax:
Practice Address - Street 1:6404 INTERNATIONAL PKWY
Practice Address - Street 2:SUITE 2100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8225
Practice Address - Country:US
Practice Address - Phone:817-233-7269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX299381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical