Provider Demographics
NPI:1700914769
Name:HOLTE, SUSAN MARIE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MARIE
Last Name:HOLTE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:DULANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:PO BOX 9054
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-9054
Mailing Address - Country:US
Mailing Address - Phone:423-467-3600
Mailing Address - Fax:423-467-3644
Practice Address - Street 1:RT 3 BOX 1700
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:VA
Practice Address - Zip Code:24263
Practice Address - Country:US
Practice Address - Phone:276-346-3590
Practice Address - Fax:276-346-3612
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VALCSW 0904006513104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker