Provider Demographics
NPI:1861907974
Name:HOLLINS, SHALANDRA (MS, LMFTA)
Entity type:Individual
Prefix:
First Name:SHALANDRA
Middle Name:
Last Name:HOLLINS
Suffix:
Gender:F
Credentials:MS, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3064 WAKE FOREST RD # 1027
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7844
Mailing Address - Country:US
Mailing Address - Phone:919-335-5601
Mailing Address - Fax:
Practice Address - Street 1:3125 POPLARWOOD CT STE 203
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-6445
Practice Address - Country:US
Practice Address - Phone:919-808-8812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12070A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist