Provider Demographics
NPI:1740817873
Name:HOLMES, AMBER NICOLE (MA, NCC, LPC)
Entity type:Individual
Prefix:MS
First Name:AMBER
Middle Name:NICOLE
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-6023
Mailing Address - Country:US
Mailing Address - Phone:318-527-3175
Mailing Address - Fax:
Practice Address - Street 1:320 PEARL ST
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-6023
Practice Address - Country:US
Practice Address - Phone:318-527-3175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8318101YP2500X
171M00000X
TX92122101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator