Provider Demographics
NPI:1518189836
Name:HOLTON, NANCY LEWIS (LMSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LEWIS
Last Name:HOLTON
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 1:1498 LONG LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-9637
Mailing Address - Country:US
Mailing Address - Phone:248-335-0632
Mailing Address - Fax:248-335-1067
Practice Address - Street 1:1498 LONG LAKE DR
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-9637
Practice Address - Country:US
Practice Address - Phone:248-335-0632
Practice Address - Fax:248-335-1067
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801058814101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health