Individual
HOLLY DECANN INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
445 DOLLEY MADISON RD STE 410, GREENSBORO, NC 27410-5167
(336) 292-1510
(336) 292-0679
Mailing address
445 DOLLEY MADISON RD STE 410, GREENSBORO, NC 27410-5167
(336) 292-1510
(336) 292-0679
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2740
NC
101YP2500X
Professional Counselor
Primary
2740
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135NF
BLUE CROSS/BLUE SHIELD
NC
01
—
188815
MEDCOST
NC
01
—
2061420
CIGNA
NC
01
—
277766-000
MAGELLAN BH
NC
Enumeration date
07/07/2006
Last updated
08/10/2021
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