1295436335 NPI number — ANN T HOLLAND LICENSED PROFESSIONAL COUNSELING PLLC

Table of content: (NPI 1295436335)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295436335 NPI number — ANN T HOLLAND LICENSED PROFESSIONAL COUNSELING PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANN T HOLLAND LICENSED PROFESSIONAL COUNSELING PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295436335
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/05/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
214 WATER ST
Provider Second Line Business Mailing Address:
SUITE 3
Provider Business Mailing Address City Name:
BOYNE CITY
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49712-2203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
231-675-3150
Provider Business Mailing Address Fax Number:
231-459-4397

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
214 WATER ST
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
BOYNE CITY
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49712-2203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
231-675-3150
Provider Business Practice Location Address Fax Number:
231-459-4397
Provider Enumeration Date:
03/15/2023

Additional Information

Authorized Official

Authorized Official Last Name:
HOLLAND
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
G
Authorized Official Title or Position:
BILLING AGENT
Authorized Official Telephone Number:
231-330-5372

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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