Provider Demographics
NPI:1164856407
Name:HOLMES, YOLI S (LCPC)
Entity Type:Individual
Prefix:MS
First Name:YOLI
Middle Name:S
Last Name:HOLMES
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:YOIL
Other - Middle Name:S
Other - Last Name:SIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:710 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62702-6324
Mailing Address - Country:US
Mailing Address - Phone:217-525-1064
Mailing Address - Fax:217-525-1651
Practice Address - Street 1:340 W STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-2061
Practice Address - Country:US
Practice Address - Phone:217-245-6126
Practice Address - Fax:217-245-4296
Is Sole Proprietor?:No
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180008769101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional