Hathaway, Holly I

Hathaway, Holly I is an individual health care provider with primary practice located at 1650 Cochrane Cir # B7500 , Fort Carson CO 80913-4613. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Hathaway, Holly I can be contacted via phone (207) 615-2620.

Contact Information

Primary practice address
1650 Cochrane Cir # B7500 Fort Carson CO 80913-4613
Phone: (207) 615-2620
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X CSW29925611 Colorado
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LC5406 Maine

Profile Details

NPI number 1730303074
LBN Legal business name Hathaway, Holly I
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2007
Last updated Jul 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730303074 NPPES
Maine MEDICAID 417130099

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