Provider Demographics
NPI:1497391585
Name:HOLT, JUNE MICHELLE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:MICHELLE
Last Name:HOLT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 EL MAR DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-1024
Mailing Address - Country:US
Mailing Address - Phone:585-402-4458
Mailing Address - Fax:
Practice Address - Street 1:295 EL MAR DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-1024
Practice Address - Country:US
Practice Address - Phone:585-402-4458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-23
Last Update Date:2019-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107940-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker