Provider Demographics
NPI:1629141684
Name:HOLMS, SUSAN JULIE (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JULIE
Last Name:HOLMS
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HANOVER ROAD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:CT
Mailing Address - Zip Code:06470
Mailing Address - Country:US
Mailing Address - Phone:203-205-0577
Mailing Address - Fax:203-205-0577
Practice Address - Street 1:44 NORTH STREET
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810
Practice Address - Country:US
Practice Address - Phone:203-205-0577
Practice Address - Fax:203-205-0577
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0033461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical