Provider Demographics
NPI:1396995429
Name:HOLDEN, JOHN J (LCSW-R)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:HOLDEN
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 3RD ST
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-1539
Mailing Address - Country:US
Mailing Address - Phone:518-463-8869
Mailing Address - Fax:518-463-8733
Practice Address - Street 1:1641 3RD ST
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-1539
Practice Address - Country:US
Practice Address - Phone:518-463-8869
Practice Address - Fax:518-463-8733
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR081637-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical