Provider Demographics
NPI:1811140411
Name:HOLLEY, HAROLD (LPC)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:
Last Name:HOLLEY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:HOLLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1909 COMMERCE AVE NW
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-6151
Mailing Address - Country:US
Mailing Address - Phone:256-734-4688
Mailing Address - Fax:256-255-0026
Practice Address - Street 1:875 WEST MORENO AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905
Practice Address - Country:US
Practice Address - Phone:719-572-6200
Practice Address - Fax:719-572-6299
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
COLPC 5628101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor