Provider Demographics
NPI:1871743427
Name:HOLSOPPLE, GARY M (MSW)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:M
Last Name:HOLSOPPLE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13498 SOUTH AVENUE EXTENSION
Mailing Address - Street 2:
Mailing Address - City:COLUMBIANA
Mailing Address - State:OH
Mailing Address - Zip Code:44408-9703
Mailing Address - Country:US
Mailing Address - Phone:330-549-0082
Mailing Address - Fax:
Practice Address - Street 1:226 N 4TH ST
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2104
Practice Address - Country:US
Practice Address - Phone:740-283-4763
Practice Address - Fax:740-283-2929
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-48391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical