Provider Demographics
NPI:1861878886
Name:SANTINO, HOLLY A (MS, LLPC, DP-C)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:A
Last Name:SANTINO
Suffix:
Gender:F
Credentials:MS, LLPC, DP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 SHATTUCK RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2329
Mailing Address - Country:US
Mailing Address - Phone:989-752-7867
Mailing Address - Fax:989-752-6830
Practice Address - Street 1:508 SHATTUCK RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2329
Practice Address - Country:US
Practice Address - Phone:989-752-7867
Practice Address - Fax:989-752-6830
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014787101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)