Cody Stonewall Hollist, PH.D.

Individual provider Active NPI Marriage & Family Therapist · Centerton, AR

NPI 1235341801 · NPPES record last updated Jul 2, 2026

Key facts

NPI
1235341801
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
115 (NE)
Practice address
1570 N Lexington PL
Centerton, AR 72719-9539
Phone
(402) 202-0506
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
115NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hollist Treatment for Adolescents and Families Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 115 NE Yes

Addresses

Primary practice location

1570 N Lexington PL
Centerton, AR 72719-9539

Mailing address

1570 N Lexington PL
Centerton, AR 72719-9539
Phone (402) 202-0506

Other providers in Centerton, AR

All providers in Centerton, AR · Marriage & Family Therapist in Arkansas

Sources for this page

Verify at the official NPI Registry.