Provider Demographics
NPI:1508281569
Name:HOLDER, TRELAN NICOLE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:TRELAN
Middle Name:NICOLE
Last Name:HOLDER
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 1:1085 WARBURTON AVE APT 517
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1013
Mailing Address - Country:US
Mailing Address - Phone:917-846-4413
Mailing Address - Fax:
Practice Address - Street 1:1085 WARBURTON AVE APT 517
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1013
Practice Address - Country:US
Practice Address - Phone:917-846-4413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0786301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical