Provider Demographics
NPI:1396799292
Name:HOLLAND, TIMOTHY LYNN (DMIN, LPC, LMFT)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:LYNN
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:DMIN, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 BLAKE ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-1572
Mailing Address - Country:US
Mailing Address - Phone:864-253-9089
Mailing Address - Fax:864-591-1232
Practice Address - Street 1:397 BLAKE ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-1572
Practice Address - Country:US
Practice Address - Phone:864-253-9089
Practice Address - Fax:864-591-1232
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1818101YP2500X
SC1960106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist