Provider Demographics
NPI:1174000715
Name:HOLT, LASHARA DENISE (LCSW, CADC)
Entity Type:Individual
Prefix:MRS
First Name:LASHARA
Middle Name:DENISE
Last Name:HOLT
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6308 MARAVIAN DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3256
Mailing Address - Country:US
Mailing Address - Phone:502-448-0638
Mailing Address - Fax:
Practice Address - Street 1:6308 MARAVIAN DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-3256
Practice Address - Country:US
Practice Address - Phone:502-448-0638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2528091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical