Provider Demographics
NPI:1467154385
Name:HOLM, ERIKA AMELIA
Entity Type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:AMELIA
Last Name:HOLM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 CENTRAL ST APT 408
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-4304
Mailing Address - Country:US
Mailing Address - Phone:978-340-3458
Mailing Address - Fax:
Practice Address - Street 1:242 GREEN ST
Practice Address - Street 2:SOUTH ENTRANCE PROFESSIONAL SUITE
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440
Practice Address - Country:US
Practice Address - Phone:978-630-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2286331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical