Provider Demographics
NPI:1881240653
Name:WRIGHT, HOLLY H (LPC)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:H
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 WHIPPOORWILL CIR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-4902
Mailing Address - Country:US
Mailing Address - Phone:229-563-1824
Mailing Address - Fax:
Practice Address - Street 1:1805 GREEN CIR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2734
Practice Address - Country:US
Practice Address - Phone:229-474-8588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC0008755101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional