Provider Demographics
NPI:1316165269
Name:GEORGE, HOLLY VASHTI (LMHC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:VASHTI
Last Name:GEORGE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:VASHTI
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:348 PUUHALE RD # 444
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-3298
Mailing Address - Country:US
Mailing Address - Phone:808-798-6188
Mailing Address - Fax:
Practice Address - Street 1:445 SEASIDE AVE APT 3004
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-5534
Practice Address - Country:US
Practice Address - Phone:808-798-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2023-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-990101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health