Provider Demographics
NPI:1093049447
Name:HOLMES, EMILY M (LCSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:HOLMES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:M
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 MSGT DAN WASSAM RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK AFB
Mailing Address - State:AR
Mailing Address - Zip Code:72099-0001
Mailing Address - Country:US
Mailing Address - Phone:501-987-8752
Mailing Address - Fax:
Practice Address - Street 1:101 MSGT DAN WASSOM RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK AFB
Practice Address - State:AR
Practice Address - Zip Code:72099-8066
Practice Address - Country:US
Practice Address - Phone:501-987-8752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker