Provider Demographics
NPI:1972989176
Name:HOLDEN, MICHELE (MED, LCPC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:MED, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:RUDYARD
Mailing Address - State:MT
Mailing Address - Zip Code:59540-0129
Mailing Address - Country:US
Mailing Address - Phone:406-355-4481
Mailing Address - Fax:
Practice Address - Street 1:105 3RD AVE NE
Practice Address - Street 2:
Practice Address - City:RUDYARD
Practice Address - State:MT
Practice Address - Zip Code:59540-0129
Practice Address - Country:US
Practice Address - Phone:406-355-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12313101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional