Carol Dutton Hollenberg, MFT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

MFT21105 Issued in CA

Practice address

503 D St.
San Rafael, CA 94901

Phone

(415) 457-5867

NPI assigned

Nov 29, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Carol Dutton Hollenberg Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1063955771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 D ST STE 4",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013864",
            "telephone_number": "415-457-5867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 D ST.",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "94901",
            "telephone_number": "415-457-5867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLENBERG",
        "first_name": "CAROL",
        "middle_name": "DUTTON",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "MFT21105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "HOLLENBERG",
            "middle_name": "DUTTON",
            "prefix": "MS.",
            "credential": "MFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Holistic Psych Care & Integrative Wellness LLC
• Eric Paul Holland
• Jennifer May Holland, RPT
• Mariko Holland, NURSE PRACTITIONER
• Matthew John Holland
• Peter L Holleran, D.C.
• Annette Holloway, PSY.D.
• Ruth A. Holly, MD
• Robert Jerome Holmberg II, M.S. COUNSELING
• Andre Holmes

• Behavior Technician in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.