Holly I Hathaway, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC5406 Issued in ME

Practice address

1650 Cochrane Cir # B7500
Fort Carson, CO 80913-4613

Phone

(207) 615-2620

NPI assigned

Apr 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730303074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 COCHRANE CIRCLE B7500",
            "address_2": "EVANS ARMY COMMUNITY HOSPITAL",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "80913",
            "telephone_number": "207-615-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR # B7500",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "207-615-2620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Saco St",
            "address_purpose": "LOCATION",
            "city": "Westbrook",
            "state": "ME",
            "postal_code": "040922856",
            "country_code": "US",
            "telephone_number": "207-591-4452 x120",
            "fax_number": "207-887-7130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "HOLLY",
        "middle_name": "I",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2022-07-21",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "CSW29925611",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "LC5406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417130099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christy Hartline, RN
• Michael Harvey, PSY.D.
• Spencer Dane Haslam
• Arthur Hastings, LCSW, LPC, LCDC, CCM
• Samantha Leigh Hatfield, OTR
• Ian Patrick Hatlee, PHARMD
• Paul Haufe, PA-C
• Thomas Joseph Havlichek, DDS
• Dale Eugene Hawkins, EFDA
• Jennifer Hawkins

• Mental Health Counselor in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.