MR. THADEUS MANDRALL HOLLOWAY (NPI# 1245597848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245597848 |
| Entity Type | Individual |
| Full Name | MR. THADEUS MANDRALL HOLLOWAY |
| Credential | LPC |
| Practice Address |
305 W Spring St Box 172 Mount Vernon GA 30445-2837 |
| Mailing Address |
Po Box 172 305 West Spring Street Mount Vernon GA 30445-0172 |
| Practice Telephone | 9124231000 |
| Practice Fax Number | 9125830115 |
| Mailing Telephone | 9124231000 |
| Mailing Fax Number | 9125830115 |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2014-10-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | LPC006790 | GA | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LPC006790 | GA | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
LPC006790 | GA | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC006790 | GA | Behavioral Health & Social Service Providers |
| Street Address |
305 W SPRING ST BOX 172 |
| City | MOUNT VERNON |
| State | GA |
| Zip Code | 30445-2837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609229475 | Tyhescia White-johnson | Counselor | 305 W Spring St, Post Office Box 172, Mount Vernon, GA 30445-2837 | 2016-07-18 |
| 1205283520 | Road To Success | Counselor | 305 W Spring St, Mount Vernon, GA 30445-2837 | 2016-05-17 |
| 1881068005 | Amber Mcarthur | Counselor | 305 W Spring St, Mount Vernon, GA 30445-2837 | 2015-11-26 |
| 1326446659 | Road To Success | Case Management | 305 W Spring St, Mount Vernon, GA 30445-2837 | 2014-12-19 |
| 1336551415 | Paulette Chavers | Counselor | 305 W Spring St, Mount Vernon, GA 30445-2837 | 2014-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396175345 | Allcare PC | Pharmacy | 115 Spring St, Mount Vernon, GA 30445 | 2013-11-12 |
| 1760750467 | Lower Oconee Community Hospital, Inc. | Family Medicine | 421 W Robinson Drive, Mount Vernon, GA 30445 | 2011-12-08 |
| 1982819124 | Duncan Mcrae House, Inc | Assisted Living Facility | 129 South Railroad Avenue, Mt. Vernon, GA 30445 | 2007-05-11 |
| 1972729580 | Meadows Regional Medical Center | Clinic/Center | 201 W. Sutton St., Mount Vernon, GA 30445 | 2007-04-18 |
| 1255409215 | County of Montgomery Health Department | Public Health or Welfare | 218 West Broad Street, Mt. Vernon, GA 30445 | 2006-11-30 |
| 1578633418 | Montgomery County Board of Education | Local Education Agency (LEA) | 403 Fulton St, Mount Vernon, GA 30445 | 2006-11-08 |
| 1194868539 | Mount Vernon Drug Company | Pharmacist | 421 S Railroad Ave, Mount Vernon, GA 30445-0195 | 2007-02-15 |
| 1497751077 | Montgomery Medical Equipment, Inc. | Pharmacy | 103 S Richardson St, Mount Vernon, GA 30445-2611 | 2005-06-28 |
| 1164547287 | Lower Oconee Community Hospital, Inc | Clinic/Center | 441 W Broad Street, Mount Vernon, GA 30445-2629 | 2007-03-20 |
| 1659741221 | Shonda Lafaye Madison | Counselor | 1110 N Minnie St, Mount Vernon, GA 30445-2716 | 2015-09-25 |
| Find all providers in zip 30445 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639790264 | Latasha Nicole Lyons | Counselor | 1004 Mulligan Dr, Mount Vernon, IL 62864-2099 | 2020-05-05 |
| 1346717147 | Worthy Life Wellness, Pllc | Counselor | 4114 N Water Tower Pl Ste F, Mount Vernon, IL 62864-6548 | 2018-10-30 |
| 1659741221 | Shonda Lafaye Madison | Counselor | 1110 N Minnie St, Mount Vernon, GA 30445-2716 | 2015-09-25 |
| 1528308293 | Lacy Dawn Woolsey | Counselor | 800 S 45th St, Mount Vernon, IL 62864-6704 | 2013-02-18 |
| 1578861985 | Daniel Carr | Counselor | 707 Highway 37 South, Mount Vernon, TX 75457 | 2011-03-09 |
| 1871897371 | Jessica Ashlock | Counselor | 201 N 27th St, Mount Vernon, IL 62864-2941 | 2010-12-27 |
| 1902108657 | Suellen Nichole Wilcox | Counselor | 118 E High St, Mount Vernon, OH 43050-3443 | 2010-12-01 |
| 1326367467 | Mary Lynn Philbeck | Counselor | 50 Lovell Ct, Mount Vernon, KY 40456-2964 | 2010-05-28 |
| 1700042082 | Thomas Lee Haan | Counselor | 1621 Freeway Dr Ste 101c, Mount Vernon, WA 98273-2462 | 2008-08-06 |
| 1326219544 | Jalane Speaks | Counselor | 278 Beiting Ln, Mount Vernon, KY 40456-6376 | 2008-03-15 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 30445 |
Please comment or provide details below to improve the information on MR. THADEUS MANDRALL HOLLOWAY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.