Provider Demographics
NPI:1629243027
Name:ANDREA HOLMES, MPH, LLC
Entity Type:Organization
Organization Name:ANDREA HOLMES, MPH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALH COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-365-8288
Mailing Address - Street 1:2555 ENTERPRISE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-1160
Mailing Address - Country:US
Mailing Address - Phone:727-365-8288
Mailing Address - Fax:727-796-2712
Practice Address - Street 1:2555 ENTERPRISE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-1160
Practice Address - Country:US
Practice Address - Phone:727-365-8288
Practice Address - Fax:727-796-2712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4627101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty