Provider Demographics
NPI:1487918058
Name:HOLLOWAY, KATHERINE JOHNSON (LCSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JOHNSON
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 JACKSON STREET EXTENSION
Mailing Address - Street 2:SUITE C #256
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303
Mailing Address - Country:US
Mailing Address - Phone:318-625-5971
Mailing Address - Fax:
Practice Address - Street 1:109 YORKTOWN DR
Practice Address - Street 2:STE B
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3673
Practice Address - Country:US
Practice Address - Phone:318-487-9895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA81731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical