Provider Demographics
NPI:1437950904
Name:MANN, HOLLY LANEA (CSAC-S)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:LANEA
Last Name:MANN
Suffix:
Gender:F
Credentials:CSAC-S
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:LANEA
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CSAC-S
Mailing Address - Street 1:5400 SAXKEY RD
Mailing Address - Street 2:
Mailing Address - City:SAXE
Mailing Address - State:VA
Mailing Address - Zip Code:23967-5746
Mailing Address - Country:US
Mailing Address - Phone:434-607-7144
Mailing Address - Fax:
Practice Address - Street 1:214 BUSH RIVER DR
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-3179
Practice Address - Country:US
Practice Address - Phone:434-392-3187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)