Provider Demographics
NPI:1902612609
Name:HOLLAND, TAMIKA D (LSW, LCADC, CCS)
Entity type:Individual
Prefix:
First Name:TAMIKA
Middle Name:D
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:LSW, LCADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 5TH RD
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-4701
Mailing Address - Country:US
Mailing Address - Phone:609-338-2418
Mailing Address - Fax:
Practice Address - Street 1:724 5TH RD
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-4701
Practice Address - Country:US
Practice Address - Phone:609-338-2418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07031400101YM0800X
NJ37LC00365800101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health