Provider Demographics
NPI:1952606170
Name:ESTEY, HOLLY L (LCSW)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:L
Last Name:ESTEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:HOLLY
Other - Middle Name:L
Other - Last Name:MARQUIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:88 HAMMOND ST STE 404
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4953
Mailing Address - Country:US
Mailing Address - Phone:207-249-3114
Mailing Address - Fax:207-262-0078
Practice Address - Street 1:88 HAMMOND ST 404
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4953
Practice Address - Country:US
Practice Address - Phone:207-249-3114
Practice Address - Fax:207-262-0078
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-19
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC140021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical