Provider Demographics
NPI:1205408648
Name:HOLZER, MOSHE (LGPC)
Entity Type:Individual
Prefix:
First Name:MOSHE
Middle Name:
Last Name:HOLZER
Suffix:
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 UNIVERSITY BLVD W APT 815
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-3320
Mailing Address - Country:US
Mailing Address - Phone:305-922-1951
Mailing Address - Fax:
Practice Address - Street 1:11201 HEALY ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-3219
Practice Address - Country:US
Practice Address - Phone:240-997-1612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11682101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health