Provider Demographics
NPI:1306361100
Name:MACGOWAN, HOLLY A (LMFT)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:A
Last Name:MACGOWAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 OXFORD ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1064
Mailing Address - Country:US
Mailing Address - Phone:541-261-1818
Mailing Address - Fax:888-768-1114
Practice Address - Street 1:325 A ST STE 1
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1970
Practice Address - Country:US
Practice Address - Phone:541-261-1818
Practice Address - Fax:888-768-1114
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2025-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORT1375101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health