Provider Demographics
NPI:1336751064
Name:PELPHREY, HOLLY (COUNSELOR TRAINEE)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:PELPHREY
Suffix:
Gender:F
Credentials:COUNSELOR TRAINEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11310 TEMPLETON DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-4545
Mailing Address - Country:US
Mailing Address - Phone:513-678-4898
Mailing Address - Fax:
Practice Address - Street 1:7102 PIPPIN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-4605
Practice Address - Country:US
Practice Address - Phone:513-900-1022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2002540-TRNE101YA0400X
OHC.2103694101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)