Provider Demographics
NPI:1205640661
Name:HOLMES, JORDAN (MFT-I)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MFT-I
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:
Other - Last Name:LEONHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT-I
Mailing Address - Street 1:770 MILL ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1321
Mailing Address - Country:US
Mailing Address - Phone:775-636-7767
Mailing Address - Fax:
Practice Address - Street 1:770 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1321
Practice Address - Country:US
Practice Address - Phone:775-636-7767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI4476101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health