Provider Demographics
NPI:1639288418
Name:HOLLIMAN, LYNN BROOKS (LSCSW)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:BROOKS
Last Name:HOLLIMAN
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 WILLIAMSBURG TER APT B302
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-7667
Mailing Address - Country:US
Mailing Address - Phone:816-859-3211
Mailing Address - Fax:
Practice Address - Street 1:2900 WILLIAMSBURG TER APT B302
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079-7667
Practice Address - Country:US
Practice Address - Phone:816-859-3211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20200126571041C0700X
KS23721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS06908OtherPROVIDER MEDICARE NUMBER
KS069838Medicare ID - Type UnspecifiedMEDICARE