Provider Demographics
NPI:1730560624
Name:HOLLINS COUNSELING SERVICES INC
Entity type:Organization
Organization Name:HOLLINS COUNSELING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER/MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:HOLLINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPCC-SC; CCMHC
Authorized Official - Phone:937-237-0071
Mailing Address - Street 1:6371 KITTYHAWK COMMONS BLVD
Mailing Address - Street 2:P.O. BOX 24264
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-4043
Mailing Address - Country:US
Mailing Address - Phone:937-237-0071
Mailing Address - Fax:937-237-0782
Practice Address - Street 1:6371 KITTYHAWK COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-4043
Practice Address - Country:US
Practice Address - Phone:937-237-0071
Practice Address - Fax:937-237-0782
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHN E. HOLLINS, JR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0001467101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2335164Medicaid