Provider Demographics
NPI:1366974636
Name:WOOD, HOLLY E (MSW, LISW-S)
Entity type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:E
Last Name:WOOD
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:WOOD
Other - Last Name:GEIGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LISW-S
Mailing Address - Street 1:285 ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2357
Mailing Address - Country:US
Mailing Address - Phone:614-558-1991
Mailing Address - Fax:
Practice Address - Street 1:75 E WILSON BRIDGE RD STE C2
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2362
Practice Address - Country:US
Practice Address - Phone:614-558-1991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-5786 SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical