1083809743 NPI number — JANINE FLAGG HOLLOWAY LMFT, & LMHC

Table of content: JANINE FLAGG HOLLOWAY LMFT, & LMHC (NPI 1083809743)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083809743 NPI number — JANINE FLAGG HOLLOWAY LMFT, & LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLLOWAY
Provider First Name:
JANINE
Provider Middle Name:
FLAGG
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT, & LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLAGG
Provider Other First Name:
JANINE
Provider Other Middle Name:
ALANE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1083809743
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
609 WASHINGTON STREET
Provider Second Line Business Mailing Address:
APT 302
Provider Business Mailing Address City Name:
WELLESLEY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02482-6464
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-964-0448
Provider Business Mailing Address Fax Number:
469-886-1887

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
609 WASHINGTON STREET
Provider Second Line Business Practice Location Address:
APT 302
Provider Business Practice Location Address City Name:
WELLESLEY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02482-6464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-964-0448
Provider Business Practice Location Address Fax Number:
469-886-1887
Provider Enumeration Date:
09/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  1465 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YM0800X , with the licence number: 9955 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: 202319 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: LMFT-46740 . This is a "BOARD OF BEHAVIORAL SCIENCES" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: LMFT-M2202001 . This is a "BOARD OF EXAMINERS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: LMFT-TPMF458 . This is a "FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: LMHC-9955 . This is a "DIVISION OF PROFESSIONAL LICENSURE, BOARD OF ALLIED HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: LMFT-2349 . This is a "BOARD FOR LICENSED PROFESSIONAL COUNSELORS, LICENSED MARITAL AND FAMILY THERAPIS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: LMFT-10724 . This is a "NC MFT LICENSURE BOARD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: LMFT-1465 . This is a "DIVISION OF PROFESSIONAL LICENSURE, BOARD OF ALLIED HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: LMFT-202319 . This is a "TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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