Provider Demographics
NPI:1396265146
Name:HOLLAND, JUDY BEASLEY (LPCA)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:BEASLEY
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 PEACH ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:FOUR OAKS
Mailing Address - State:NC
Mailing Address - Zip Code:27524-9745
Mailing Address - Country:US
Mailing Address - Phone:919-464-8308
Mailing Address - Fax:
Practice Address - Street 1:1044 PEACH ORCHARD RD
Practice Address - Street 2:
Practice Address - City:FOUR OAKS
Practice Address - State:NC
Practice Address - Zip Code:27524-9745
Practice Address - Country:US
Practice Address - Phone:919-464-8308
Practice Address - Fax:984-202-2275
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A13001101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional