Provider Demographics
NPI:1114695624
Name:HOLMES, ALEX (LSW)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:HOLMES
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 LINCOLN HWY E STE 100
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-3347
Mailing Address - Country:US
Mailing Address - Phone:717-947-6535
Mailing Address - Fax:
Practice Address - Street 1:1929 LINCOLN HWY E STE 150
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-3685
Practice Address - Country:US
Practice Address - Phone:717-397-7625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW134991104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker