Brenda B Hollis, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC000819 Issued in GA

Practice address

1626 Frederica Rd
Suite 203
St Simons Island, GA 31522-2529

Phone

(912) 638-0180

Fax

(912) 638-0181

NPI assigned

Aug 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Brenda B Hollis, LPC, PC

  • Professional Counselor
  • St Simons Island, GA
  • NPI 1407058175
  NPD (past) Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912019084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 FREDERICA RD",
            "address_2": "SUITE 203",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222529",
            "telephone_number": "912-638-0180",
            "fax_number": "912-638-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 FREDERICA RD",
            "address_2": "SUITE 203",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222529",
            "telephone_number": "912-638-0180",
            "fax_number": "912-638-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIS",
        "first_name": "BRENDA",
        "middle_name": "B",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC000819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL CON",
            "identifier": "LPC000819",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in St Simons Island, GA
• Providers in St Simons Island, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.