Provider Demographics
NPI:1952516106
Name:GOLIWAS, HOLLY LYNN BOYLE (MA, LPA)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:LYNN BOYLE
Last Name:GOLIWAS
Suffix:
Gender:F
Credentials:MA, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 PATTON AVE STE D
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2652
Mailing Address - Country:US
Mailing Address - Phone:828-260-1756
Mailing Address - Fax:828-253-4163
Practice Address - Street 1:1316 PATTON AVE STE D
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2652
Practice Address - Country:US
Practice Address - Phone:828-260-1756
Practice Address - Fax:828-253-4163
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3381103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6107496Medicaid