Provider Demographics
NPI:1811919475
Name:HOLLEMAN, BARBARA A (LICSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:HOLLEMAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 RICHARD RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-5812
Mailing Address - Country:US
Mailing Address - Phone:781-862-2304
Mailing Address - Fax:
Practice Address - Street 1:15 RICHARD RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-5812
Practice Address - Country:US
Practice Address - Phone:781-862-2304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1045281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical