Doctor Name: | MICHAEL HOLLEY |
NPI Number: | 1548666969 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | R016683-1 |
Business Practice Address: | 211 Church St Saratoga Spgs, NY - 128661003 |
Business Phone Number: | 5185838405 |
Business Fax Number: | |
Mailing Address: | 15 Forestbrook Dr, BALLSTON LAKE |
State: | NY |
Postal Code: | 120191731 |
Phone Number: | 5183699022 |
Fax Number: | |
NPI Enumeration Date: | 11/12/2014 |
NPI Last Update Date: | 11/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | R016683-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |