Provider Demographics
NPI:1972714160
Name:ZIRKLE, HOLLY (LICSW)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:ZIRKLE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 COMMERCE WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03825-3544
Mailing Address - Country:US
Mailing Address - Phone:603-664-9500
Mailing Address - Fax:603-664-9520
Practice Address - Street 1:8 COMMERCE WAY STE 2
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NH
Practice Address - Zip Code:03825-3544
Practice Address - Country:US
Practice Address - Phone:603-664-9500
Practice Address - Fax:603-664-9520
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-27
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH8701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3071810Medicaid
NHRE535202OtherMEDICARE