Provider Demographics
NPI:1528288891
Name:HOLLEY, WILLIAM GRANT (LCSW MSW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GRANT
Last Name:HOLLEY
Suffix:
Gender:M
Credentials:LCSW MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20635 ABBEY WOODS CT N STE 209
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-3188
Mailing Address - Country:US
Mailing Address - Phone:815-640-1669
Mailing Address - Fax:
Practice Address - Street 1:20635 ABBEY WOODS CT N STE 209
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-3188
Practice Address - Country:US
Practice Address - Phone:815-640-1669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149004943 LCSW1041C0700X
IL1490049431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical