Provider Demographics
NPI:1427514603
Name:EISENBRANDT, HOLLY ELLIS (LPC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:ELLIS
Last Name:EISENBRANDT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 VISTA CIR APT 510
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-6103
Mailing Address - Country:US
Mailing Address - Phone:412-963-1352
Mailing Address - Fax:
Practice Address - Street 1:1350 OLD FREEPORT RD STE 1A
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3122
Practice Address - Country:US
Practice Address - Phone:412-406-7734
Practice Address - Fax:412-406-7742
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011041101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional