Provider Demographics
NPI:1790182087
Name:HOLT, ROSEMARY NORDONE (MED, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:NORDONE
Last Name:HOLT
Suffix:
Gender:F
Credentials:MED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11E HERITAGE VLG
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-5656
Mailing Address - Country:US
Mailing Address - Phone:214-458-4372
Mailing Address - Fax:
Practice Address - Street 1:11E HERITAGE VLG
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-5656
Practice Address - Country:US
Practice Address - Phone:214-458-4372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-02
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT101YP2500X
TX65676101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty