Provider Demographics
NPI:1811670961
Name:UNDERHILL, HOLLY CARLE (LMHCA)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:CARLE
Last Name:UNDERHILL
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4327 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-1059
Mailing Address - Country:US
Mailing Address - Phone:207-505-5789
Mailing Address - Fax:
Practice Address - Street 1:101 W CASCADE WAY STE 103
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6000
Practice Address - Country:US
Practice Address - Phone:509-413-2242
Practice Address - Fax:509-922-7947
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61594038101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health