Provider Demographics
NPI:1295778728
Name:HOLMES, DONITA PATRICIA (LISW-CP)
Entity type:Individual
Prefix:DR
First Name:DONITA
Middle Name:PATRICIA
Last Name:HOLMES
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 SAWGRASS RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-7009
Mailing Address - Country:US
Mailing Address - Phone:803-207-0993
Mailing Address - Fax:866-591-1741
Practice Address - Street 1:737 SAWGRASS RIDGE CT
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-7009
Practice Address - Country:US
Practice Address - Phone:803-207-0993
Practice Address - Fax:866-591-1741
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
NCC0054801041C0700X
SC87801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1295778728Medicaid
NC6106559Medicaid
NC6106559Medicaid