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Individual

BEVERLY OHNECK HOLLY

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
R.N., LCSW

Contact information

Practice address
115 N COLLEGE AVE, STE. 213, BLOOMINGTON, IN 47404-3972
(812) 333-8948
Mailing address
115 N COLLEGE AVE, STE. 213, BLOOMINGTON, IN 47404-3972
(812) 333-8948

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
34002760
IN
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
28043760
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000251127
ANTHEM
IN
Enumeration date
02/09/2006
Last updated
09/11/2025
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