Provider Demographics
NPI:1740877091
Name:HOLLIS-SAPP, BERINDA
Entity type:Individual
Prefix:
First Name:BERINDA
Middle Name:
Last Name:HOLLIS-SAPP
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4504 SADDLE DR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-7043
Mailing Address - Country:US
Mailing Address - Phone:404-889-7667
Mailing Address - Fax:
Practice Address - Street 1:4757 ARGAND DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-9344
Practice Address - Country:US
Practice Address - Phone:404-889-7667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker