1922118835 NPI number — MRS. JUDY MARIE HOLT NCC LPC

Table of content: MRS. JUDY MARIE HOLT NCC LPC (NPI 1922118835)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922118835 NPI number — MRS. JUDY MARIE HOLT NCC LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLT
Provider First Name:
JUDY
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NCC LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922118835
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
110 MC GUIRE CIRCLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PISGAH FOREST
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28768-8726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-884-9719
Provider Business Mailing Address Fax Number:
828-862-4727

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
372 MONTFORD AVE
Provider Second Line Business Practice Location Address:
FINE PSYCHOLOGICAL ASSOCIATES
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28801-1050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-254-0308
Provider Business Practice Location Address Fax Number:
828-254-0358
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  4512 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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