Basic Information
| Provider Information | |||||||||
| NPI: | 1538484142 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SINKS | ||||||||
| FirstName: | HOLLY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LCPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1803 COLONIAL DR | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | IL | ||||||||
| PostalCode: | 629596454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6189975336 | ||||||||
| FaxNumber: | 6189932969 | ||||||||
| Practice Location | |||||||||
| Address1: | 1307 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | IL | ||||||||
| PostalCode: | 629591139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6189975336 | ||||||||
| FaxNumber: | 6189932969 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2010 | ||||||||
| LastUpdateDate: | 04/07/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 180.004894 | IL | N | Behavioral Health & Social Service Providers | Counselor | 101YA0400X | 180.004894 | IL | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.