Provider Demographics
NPI:1376601070
Name:HOLMES-MCLEMORE, CHRISTINA L (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:HOLMES-MCLEMORE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 GRAVEL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EVA
Mailing Address - State:AL
Mailing Address - Zip Code:35621-7637
Mailing Address - Country:US
Mailing Address - Phone:256-612-1022
Mailing Address - Fax:256-432-2783
Practice Address - Street 1:717 HIGHWAY 67 S STE 2
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-6351
Practice Address - Country:US
Practice Address - Phone:256-432-2782
Practice Address - Fax:256-432-2783
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2078C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051559695Medicare PIN