Provider Demographics
NPI:1912789660
Name:HOLLIS, ALICIA A (EDS, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:A
Last Name:HOLLIS
Suffix:
Gender:F
Credentials:EDS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 NE RICE RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5849
Mailing Address - Country:US
Mailing Address - Phone:816-347-3069
Mailing Address - Fax:816-347-3200
Practice Address - Street 1:12401 E 43RD ST S STE 121
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-5925
Practice Address - Country:US
Practice Address - Phone:816-500-6436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
297566101YP2500X
MO339799101YS0200X
MO2022011342101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool