Jennifer Elizabeth Holdaway, LAPC
Individual provider Active NPI Professional Counselor · Chickamauga, GA
NPI 1346410941 · NPPES record last updated Mar 10, 2008
Key facts
- NPI
- 1346410941
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- APC001897 (GA)
- Practice address
- 107 Alex Dr
Chickamauga, GA 30707-4154 - Phone
- (706) 539-2680
- NPI assigned
- Mar 10, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APC001897 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lookout Mountain Community Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | APC001897 | GA | Yes |
Addresses
Primary practice location
107 Alex Dr
Chickamauga, GA 30707-4154
Mailing address
107 Alex Dr
Chickamauga, GA 30707-4154
Phone (706) 539-2680
Other providers in Chickamauga, GA
- Douglas M Graydon
- Willis Greer
- Shaina Davis Gross
- Kristen C Hampton
- Lori Kristen Haney
- Hutcheson Primary Care, LLC
- Maureen Irvin
- Leslie Jackson Carbine
- Leslie Elizabeth Kendrick
- Jason David Lacy
All providers in Chickamauga, GA · Professional Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.