Provider Demographics
NPI:1184330623
Name:HOLM PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:HOLM PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HOLM
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP
Authorized Official - Phone:612-405-8409
Mailing Address - Street 1:1585 THOMAS CENTER DR STE 106
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-3007
Mailing Address - Country:US
Mailing Address - Phone:612-405-8409
Mailing Address - Fax:
Practice Address - Street 1:1585 THOMAS CENTER DR STE 106
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3007
Practice Address - Country:US
Practice Address - Phone:612-405-8409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty