Provider Demographics
NPI:1609212489
Name:HOLT, TERRY LEE II (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:LEE
Last Name:HOLT
Suffix:II
Gender:M
Credentials:MA, LPC
Other - Prefix:MR
Other - First Name:T.L.
Other - Middle Name:
Other - Last Name:HOLT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:1608 WILLIAMS DR STE 301
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-3195
Mailing Address - Country:US
Mailing Address - Phone:615-653-4115
Mailing Address - Fax:615-413-9995
Practice Address - Street 1:1608 WILLIAMS DR STE 301
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3195
Practice Address - Country:US
Practice Address - Phone:615-653-4115
Practice Address - Fax:615-413-9995
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3010101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional