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:
03/29/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
609 WASHINGTON ST APT 302
Provider Second Line Business Mailing Address:
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 ST APT 302
Provider Second Line Business Practice Location Address:
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:  LMFT-202319 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • 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: LMFT-1465 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • 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: LMFT-46740 . This is a "BOARD OF BEHAVIORAL SCIENCES" identifier , issued by the state of ( CA ) . 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-202319 . This is a "TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL" identifier , issued by the state of ( TX ) . 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-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".




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