Provider Demographics
NPI:1639833825
Name:BILYEU-HOLMES, JACQUELINE MICHELE (LMSW)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:MICHELE
Last Name:BILYEU-HOLMES
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 1:3365 KIMBALL AVE
Mailing Address - Street 2:UNIT 100
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5700
Mailing Address - Country:US
Mailing Address - Phone:319-214-2159
Mailing Address - Fax:319-349-3002
Practice Address - Street 1:3356 KIMBALL AVE # 100
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5700
Practice Address - Country:US
Practice Address - Phone:319-214-2159
Practice Address - Fax:319-349-3002
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1094871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical