Individual provider · Type 1 NPI

Shaconda Larece Holloway, L.C.S.W.

Clinical Social Worker · Suffolk, VA

NPI number 1114463700 Active

Practice location

5268 Godwin Blvd, Western Tidewater Mental Health
Suffolk, VA 23434

Call (757) 255-7117 Map

Fax (757) 255-7139

Mailing address

3239 Joplin Ln
Chesapeake, VA 23323-1197

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X0904009488 (VA)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1114463700

Shaconda Larece Holloway, L.C.S.W.'s National Provider Identifier is 1114463700, issued on Jan 6, 2017. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Suffolk, VA. The record was last updated on Jan 6, 2017.