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Contact Information

SHACONDA L HOLLOWAY, LCSW
5268 GODWIN BLVD
WESTERN TIDEWATER MENTAL HEALTH
SUFFOLK, VA23434
 Phone: 757-255-7117
 Fax: 757-255-7139
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for SHACONDA L HOLLOWAY · (Female)

NPI Number 1114463700
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 01/06/2017
Last updated 01/06/2017 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • VA License # 0904009488
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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