Provider Demographics
NPI:1669681409
Name:HOLMES, WILLIAM C (MSW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:HOLMES
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3048 MARTZ PL
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3520
Mailing Address - Country:US
Mailing Address - Phone:989-295-5884
Mailing Address - Fax:
Practice Address - Street 1:3048 MARTZ PL
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3520
Practice Address - Country:US
Practice Address - Phone:989-295-5884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010625281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0890800Medicare ID - Type Unspecified