Provider Demographics
NPI:1669970513
Name:MEANS-BEAMAN, HOLLIE ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:HOLLIE
Middle Name:ELIZABETH
Last Name:MEANS-BEAMAN
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 1:1291 STANLEY RD NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-4359
Mailing Address - Country:US
Mailing Address - Phone:770-427-0417
Mailing Address - Fax:
Practice Address - Street 1:1291 STANLEY RD NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-4359
Practice Address - Country:US
Practice Address - Phone:770-427-0417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-25
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSW006607101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional