Provider Demographics
NPI:1457906604
Name:THOMPSON FELTS, HOLLY RAEANN (LPC)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:RAEANN
Last Name:THOMPSON FELTS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:THOMPSON
Other - Last Name:FELTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13330 LEOPARD ST STE 34
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-4481
Mailing Address - Country:US
Mailing Address - Phone:361-446-6460
Mailing Address - Fax:
Practice Address - Street 1:13330 LEOPARD ST STE 34
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-4481
Practice Address - Country:US
Practice Address - Phone:361-446-6460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82008101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional