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Mr. Thadeus Mandrall Holloway, LPC
Professional Counselor in Mount Vernon, Georgia
NPI 1245597848

Thadeus Mandrall Holloway is a Professional Counselor based in Mount Vernon, GA and is specialized in Professional. Thadeus Mandrall Holloway practices in Mount Vernon, GA and has the professional credentials of LPC. The NPI Number for Thadeus Mandrall Holloway is 1245597848 and holds a License No. LPC006790 (Georgia).

The current practice location address for Thadeus Mandrall Holloway is 305 W Spring St, Mount Vernon, GA and can be reached out via phone at 912-423-1000 and via fax at 912-583-0115.

Location: 305 W Spring St, Mount Vernon, GA, 30445-0172
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1245597848
Provider Name
Thadeus Mandrall Holloway
Credential
LPC
Provider Entity Type
Individual
Gender
Male
Address
305 W Spring St, Mount Vernon, GA, 30445-0172
Phone Number
912-423-1000
Fax Number
912-583-0115
Provider Enumeration Date
04/19/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
305 W Spring St
City
Mount Vernon
State
Georgia
Zip
30445-2837
Phone Number
912-423-1000
Fax Number
912-583-0115
person
Provider Business Mailing Address Details
Address
305 W Spring St
City
Mount Vernon
State
Georgia
Zip
30445-2837
Phone Number
912-423-1000
Fax Number
912-583-0115
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
LPC006790 (Georgia)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
LPC006790 (Georgia)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
LPC006790 (Georgia)
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
LPC006790 (Georgia)
Definition
Definition to come...
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