Basic Information
| Provider Information | |||||||||
| NPI: | 1023572328 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOLLOWAY | ||||||||
| FirstName: | VIRGINIA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | P.I.P, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 TWINING ST BLDG MAXWELL | ||||||||
| Address2: | |||||||||
| City: | MONTGOMERY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 361126027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3359533368 | ||||||||
| FaxNumber: | 3349538607 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 SOUTH TWINING STREET BUILDING 760 | ||||||||
| Address2: | |||||||||
| City: | MAXWELL | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3349533368 | ||||||||
| FaxNumber: | 3349538607 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2019 | ||||||||
| LastUpdateDate: | 04/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 1459-3905C | AL | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.