Provider Demographics
NPI:1356823538
Name:CARTER, HOLLY MARIE (LLMSW)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:MARIE
Last Name:CARTER
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:MS
Other - First Name:HOLLY
Other - Middle Name:MARIE
Other - Last Name:BOLOGNA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4308 MERRIMAN LOOP
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-5213
Mailing Address - Country:US
Mailing Address - Phone:810-348-7926
Mailing Address - Fax:
Practice Address - Street 1:2020 E GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-2478
Practice Address - Country:US
Practice Address - Phone:517-545-5944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801100539101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health