Provider Demographics
NPI:1194443358
Name:DANNER, HOLLY (MSW, LGSW, MHA)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:DANNER
Suffix:
Gender:F
Credentials:MSW, LGSW, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 COOMBS FARM RD STE 202
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-0803
Mailing Address - Country:US
Mailing Address - Phone:304-318-7752
Mailing Address - Fax:
Practice Address - Street 1:7000 COOMBS FARM RD STE 202
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-0803
Practice Address - Country:US
Practice Address - Phone:304-318-7752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP00946323104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVBP00946323OtherLICENCE