Provider Demographics
NPI:1023436979
Name:HOLTZ, JAMES (LPC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HOLTZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5650 N GREEN BAY AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-4446
Mailing Address - Country:US
Mailing Address - Phone:262-789-1191
Mailing Address - Fax:414-921-5652
Practice Address - Street 1:5650 N GREEN BAY AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53209-4446
Practice Address - Country:US
Practice Address - Phone:262-789-1191
Practice Address - Fax:414-921-5652
Is Sole Proprietor?:No
Enumeration Date:2014-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WI7160-125101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor