Provider Demographics
NPI:1851648430
Name:HOLLIS, MIYISHA (MS, LMFT)
Entity type:Individual
Prefix:MRS
First Name:MIYISHA
Middle Name:
Last Name:HOLLIS
Suffix:
Gender:
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8444 ORCHARD RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6823
Mailing Address - Country:US
Mailing Address - Phone:702-506-2661
Mailing Address - Fax:
Practice Address - Street 1:801 S RANCHO DR STE C3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3858
Practice Address - Country:US
Practice Address - Phone:702-385-2153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01170-I101YA0400X
NV4238106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)