Provider Demographics
NPI:1205325842
Name:CHIQUITA K. HOLT COUNSELING
Entity type:Organization
Organization Name:CHIQUITA K. HOLT COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR/COUNSELOR/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHIQUITA
Authorized Official - Middle Name:KAWANA
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, LPC
Authorized Official - Phone:870-659-6434
Mailing Address - Street 1:P.O. BOX 171
Mailing Address - Street 2:(S.A.A.)
Mailing Address - City:STUTTGART
Mailing Address - State:AR
Mailing Address - Zip Code:72160
Mailing Address - Country:US
Mailing Address - Phone:870-659-6434
Mailing Address - Fax:
Practice Address - Street 1:201 EAST 16TH STREET
Practice Address - Street 2:(S.A.A.)
Practice Address - City:STUTTGART
Practice Address - State:AR
Practice Address - Zip Code:72160
Practice Address - Country:US
Practice Address - Phone:870-659-6434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1307083101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty