Provider Demographics
NPI:1881052249
Name:JENNINGS, HOLLY M (LMHC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:M
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4051 MCLAUGHLIN RD
Mailing Address - Street 2:
Mailing Address - City:MC KEAN
Mailing Address - State:PA
Mailing Address - Zip Code:16426-2032
Mailing Address - Country:US
Mailing Address - Phone:814-823-9363
Mailing Address - Fax:
Practice Address - Street 1:4051 MCLAUGHLIN RD
Practice Address - Street 2:
Practice Address - City:MC KEAN
Practice Address - State:PA
Practice Address - Zip Code:16426-2032
Practice Address - Country:US
Practice Address - Phone:267-538-0568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006835101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health