Holly Rae Willard, BS,CCS,CADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1357 Issued in AR

Practice address

112 S Izard St
Forrest City, AR 72335-3810

Phone

(870) 630-1990

Fax

(870) 633-2624

NPI assigned

Jul 7, 2011

Last updated

Jul 7, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1861789190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S IZARD ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723353810",
            "telephone_number": "870-630-1990",
            "fax_number": "870-633-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S IZARD ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723353810",
            "telephone_number": "870-630-1990",
            "fax_number": "870-633-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "HOLLY",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "BS,CCS,CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-07",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AR",
            "license": "1357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Whitley, CASE MANAGER
• Brooke Elizabeth Cicero Wiggins, DMD
• Lynzi Elizabeth Wiggins, APRN
• Diana Wilborn
• Jordan Wilkison, LAC
• Kiffany Williams
• Meredith Anne Williams, M.D.
• Shontel Denise Wilson, MS,CCC-SLP
• Lashunda Winfrey, CM/ACTIVITY THERP.
• Eric R Wood, CRNA

• Addiction (Substance Use Disorder) Counselor in Forrest City, AR
• Providers in Forrest City, AR by specialty
• Addiction (Substance Use Disorder) Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.