Provider Demographics
NPI:1548815574
Name:HOLBROOK, LINDA MILLIAN (LPC)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:MILLIAN
Last Name:HOLBROOK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3483 WESTON DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-3100
Mailing Address - Country:US
Mailing Address - Phone:440-281-3295
Mailing Address - Fax:
Practice Address - Street 1:33480 LIBERTY PKWY
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-2670
Practice Address - Country:US
Practice Address - Phone:440-732-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1901704101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty