Provider Demographics
NPI:1376642884
Name:HOLT, EDGAR JOE JR (PHD, LMFT, LPC)
Entity Type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:JOE
Last Name:HOLT
Suffix:JR
Gender:M
Credentials:PHD, LMFT, LPC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1117 GEORGIA AVE STE D
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-6127
Mailing Address - Country:US
Mailing Address - Phone:803-752-0404
Mailing Address - Fax:888-384-2250
Practice Address - Street 1:1117 GEORGIA AVE
Practice Address - Street 2:STE D
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-3012
Practice Address - Country:US
Practice Address - Phone:803-278-4708
Practice Address - Fax:803-202-0360
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2020-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC809101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional