Provider Demographics
NPI:1902058654
Name:SEERLEY, HOLLY ANN (MFT)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:ANN
Last Name:SEERLEY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MILLWOOD ST
Mailing Address - Street 2:OFFICE 6
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2066
Mailing Address - Country:US
Mailing Address - Phone:415-383-6656
Mailing Address - Fax:
Practice Address - Street 1:10 MILLWOOD ST
Practice Address - Street 2:OFFICE 6
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2066
Practice Address - Country:US
Practice Address - Phone:415-383-6656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC14286101Y00000X, 101YM0800X, 101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional