Provider Demographics
NPI:1578023420
Name:HOLLAND, AMBER MARIE (LLPC)
Entity type:Individual
Prefix:MS
First Name:AMBER
Middle Name:MARIE
Last Name:HOLLAND
Suffix:
Gender:
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MI
Mailing Address - Zip Code:49230-0279
Mailing Address - Country:US
Mailing Address - Phone:517-550-5423
Mailing Address - Fax:517-245-1911
Practice Address - Street 1:176 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:MI
Practice Address - Zip Code:49230
Practice Address - Country:US
Practice Address - Phone:517-550-5423
Practice Address - Fax:517-245-1911
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI01016945101Y00000X
MI6401223153101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401016945OtherSTATE OF MICHIGAN LICENSE