Individual provider · Type 1 NPI

Thadeus Mandrall Holloway, LPC

Professional Counselor · Mount Vernon, GA

NPI number 1245597848 Active

Practice location

305 W Spring St, Box 172
Mount Vernon, GA 30445-2837

Call (912) 423-1000 Map

Fax (912) 583-0115

Mailing address

PO Box 172, 305 West Spring Street
Mount Vernon, GA 30445-0172

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XLPC006790 (GA)
Addiction (Substance Use Disorder) Counselor 101YA0400XLPC006790 (GA)
Mental Health Counselor 101YM0800XLPC006790 (GA)
Professional Counselor Primary 101YP2500XLPC006790 (GA)

Professional Counselor: Definition to come...

5 other providers at this address

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About NPI 1245597848

Thadeus Mandrall Holloway, LPC's National Provider Identifier is 1245597848, issued on Apr 19, 2012. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Mount Vernon, GA. The record was last updated on Oct 20, 2014.