Provider Demographics
NPI:1265655054
Name:HOLEMAN, VIRGINIA TODD (PHD, LMFT)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:TODD
Last Name:HOLEMAN
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 N LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WILMORE
Mailing Address - State:KY
Mailing Address - Zip Code:40390
Mailing Address - Country:US
Mailing Address - Phone:859-858-2212
Mailing Address - Fax:859-858-2168
Practice Address - Street 1:204 N LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:WILMORE
Practice Address - State:KY
Practice Address - Zip Code:40390-1199
Practice Address - Country:US
Practice Address - Phone:859-858-2212
Practice Address - Fax:859-858-2168
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY342106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist