1316022619 NPI number — SHARON R HOLLOWAY LCSW-C

Table of content: SHARON R HOLLOWAY LCSW-C (NPI 1316022619)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316022619 NPI number — SHARON R HOLLOWAY LCSW-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLLOWAY
Provider First Name:
SHARON
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOLLOWAY-GENTLEMAN
Provider Other First Name:
SHARON
Provider Other Middle Name:
R
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW-C
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1316022619
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2931 E BIDDLE ST
Provider Second Line Business Mailing Address:
PATIENT ACCOUNTING
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21213-3939
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-923-1886
Provider Business Mailing Address Fax Number:
443-923-1875

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7000 TUDSBURY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21244-2675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-298-7000
Provider Business Practice Location Address Fax Number:
410-448-7366
Provider Enumeration Date:
10/26/2006

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: 1041C0700X , with the licence number:  10622 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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