Provider Demographics
NPI:1083809743
Name:HOLLOWAY, JANINE FLAGG (LMFT, LMHC)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:FLAGG
Last Name:HOLLOWAY
Suffix:
Gender:
Credentials:LMFT, LMHC
Other - Prefix:
Other - First Name:JANINE
Other - Middle Name:ALANE
Other - Last Name:FLAGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:609 WASHINGTON ST APT 302
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-6464
Mailing Address - Country:US
Mailing Address - Phone:469-964-0448
Mailing Address - Fax:469-886-1887
Practice Address - Street 1:609 WASHINGTON ST APT 302
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-6464
Practice Address - Country:US
Practice Address - Phone:469-964-0448
Practice Address - Fax:469-886-1887
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLMFT-202319106H00000X
MA9955101YM0800X
MALMFT-1465106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARLMFT-M2202001OtherBOARD OF EXAMINERS
FLLMFT-TPMF458OtherFLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE
CALMFT-46740OtherBOARD OF BEHAVIORAL SCIENCES
MALMHC-9955OtherDIVISION OF PROFESSIONAL LICENSURE, BOARD OF ALLIED HEALTH
TXLMFT-202319OtherTEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL
NCLMFT-10724OtherNC MFT LICENSURE BOARD
MALMFT-1465OtherDIVISION OF PROFESSIONAL LICENSURE, BOARD OF ALLIED HEALTH
TNLMFT-2349OtherBOARD FOR LICENSED PROFESSIONAL COUNSELORS, LICENSED MARITAL AND FAMILY THERAPIS