Individual
HOLLY MIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
131 N JUDD PKWY NE UNIT 82, FUQUAY VARINA, NC 27526-2392
(404) 824-7880
Mailing address
131 N JUDD PKWY NE UNIT 82, FUQUAY VARINA, NC 27526-2392
(404) 824-7880
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
LPC5821
GA
Other
Enumeration date
09/17/2012
Last updated
06/22/2025
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