Provider Demographics
NPI:1093865842
Name:HOLT, JAMES L (MSW, LMHP LIMHP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:HOLT
Suffix:
Gender:M
Credentials:MSW, LMHP LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 O ST STE 204
Mailing Address - Street 2:204
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-1647
Mailing Address - Country:US
Mailing Address - Phone:402-706-4374
Mailing Address - Fax:
Practice Address - Street 1:1941 S 42 ST
Practice Address - Street 2:STE 430
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2987
Practice Address - Country:US
Practice Address - Phone:402-706-4374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1923101YM0800X
NE9081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE82062OtherBLUE CROSS BLUE SHIELD