Provider Demographics
NPI:1174133771
Name:HOLLIMAN, REUBEN COUNCIL JR (RMHCI)
Entity type:Individual
Prefix:MR
First Name:REUBEN
Middle Name:COUNCIL
Last Name:HOLLIMAN
Suffix:JR
Gender:M
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 RIVERSIDE DR APT 1320
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7606
Mailing Address - Country:US
Mailing Address - Phone:229-630-1792
Mailing Address - Fax:
Practice Address - Street 1:755 RIVERSIDE DR APT 1320
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7606
Practice Address - Country:US
Practice Address - Phone:229-630-1792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH19657101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health