Provider Demographics
NPI:1538976691
Name:HOLLAND, KORI REBEKAH (LPC MHSP)
Entity type:Individual
Prefix:MS
First Name:KORI
Middle Name:REBEKAH
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:LPC MHSP
Other - Prefix:
Other - First Name:KORI
Other - Middle Name:REBEKAH
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:918 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-6720
Mailing Address - Country:US
Mailing Address - Phone:865-221-0900
Mailing Address - Fax:
Practice Address - Street 1:402 GREENBELT DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-5702
Practice Address - Country:US
Practice Address - Phone:865-224-6125
Practice Address - Fax:865-338-5383
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-12
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7682101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional