Holston, Amanda P

Holston, Amanda P is an individual health care provider with primary practice located at 323 Marion Pike Ste 1 , Coal Grove OH 45638-2958. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Holston, Amanda P can be contacted via phone (740) 237-4981.

Contact Information

Primary practice address
323 Marion Pike Ste 1 Coal Grove OH 45638-2958
Phone: (740) 237-4981
Fax: (877) 325-2816
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Other Service Providers / Peer Specialist 175T00000X APS.003685 Ohio
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CDCA.170195 Ohio

Profile Details

NPI number 1902430051
LBN Legal business name Holston, Amanda P
Credentials CDCA.170195
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2020
Last updated May 19th, 2023 - about last year

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 1902430051 NPPES
Ohio MEDICAID 0392689

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