Provider Demographics
NPI:1831455492
Name:MORIN, HOLLY JASMINE (MED, LCPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:JASMINE
Last Name:MORIN
Suffix:
Gender:F
Credentials:MED, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 POOL ST STE 336
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-2833
Mailing Address - Country:US
Mailing Address - Phone:207-618-8894
Mailing Address - Fax:207-331-8852
Practice Address - Street 1:180 POOL ST STE 336
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-2833
Practice Address - Country:US
Practice Address - Phone:207-618-8894
Practice Address - Fax:207-331-8852
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4430101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty