1174948327 NPI number — MS. HOLLY MARIE HYLER LMHC

Table of content: MS. HOLLY MARIE HYLER LMHC (NPI 1174948327)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174948327 NPI number — MS. HOLLY MARIE HYLER LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HYLER
Provider First Name:
HOLLY
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHEPHEARD
Provider Other First Name:
HOLLY
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMHC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174948327
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
NEW SEASONS
Provider Second Line Business Mailing Address:
2500 MAITLAND CENTER PARKWAY STE 250
Provider Business Mailing Address City Name:
MAITLAND
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32751
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-284-7074
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NEW SEASONS
Provider Second Line Business Practice Location Address:
2500 MAITLAND CENTER PARKWAY STE 250
Provider Business Practice Location Address City Name:
MAITLAND
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-284-7074
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/25/2014

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: 101YM0800X , with the licence number:  MH12358 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 112691600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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