Provider Demographics
NPI:1699576744
Name:FORAKER, HOLLY (LPMHC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:FORAKER
Suffix:
Gender:
Credentials:LPMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S DUPONT HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3778
Mailing Address - Country:US
Mailing Address - Phone:302-313-1072
Mailing Address - Fax:
Practice Address - Street 1:222 S DUPONT HWY STE 102
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-3778
Practice Address - Country:US
Practice Address - Phone:302-313-1072
Practice Address - Fax:302-883-8202
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0011564101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health