Provider Demographics
NPI:1912417387
Name:WARREN, HOLLY KIM (LCDC, LPC)
Entity type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:KIM
Last Name:WARREN
Suffix:
Gender:F
Credentials:LCDC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8207 HUDSON AVE STE D
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2805
Mailing Address - Country:US
Mailing Address - Phone:806-318-8814
Mailing Address - Fax:
Practice Address - Street 1:8207 HUDSON AVE STE D
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2805
Practice Address - Country:US
Practice Address - Phone:806-318-8814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85096101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health