Provider Demographics
NPI:1770957516
Name:HOLNESS, CHRISAN JANELL (LCSWA)
Entity type:Individual
Prefix:
First Name:CHRISAN
Middle Name:JANELL
Last Name:HOLNESS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 RANBURNE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-3673
Mailing Address - Country:US
Mailing Address - Phone:540-327-0092
Mailing Address - Fax:
Practice Address - Street 1:3000 RANBURNE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-3673
Practice Address - Country:US
Practice Address - Phone:540-327-0092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0098101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical