Provider Demographics
NPI:1770966111
Name:MCCLOUD, HOLLY R (LMFT)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:R
Last Name:MCCLOUD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:R
Other - Last Name:CONNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:3618 BRAMBLETON AVE STE D
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3659
Mailing Address - Country:US
Mailing Address - Phone:540-206-8265
Mailing Address - Fax:540-266-1735
Practice Address - Street 1:3618 BRAMBLETON AVE STE D
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3659
Practice Address - Country:US
Practice Address - Phone:540-206-8265
Practice Address - Fax:540-266-1735
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional