Provider Demographics
NPI:1750560603
Name:HOLE, YVONNE (LCMHC)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:HOLE
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 CLUFF RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-3365
Mailing Address - Country:US
Mailing Address - Phone:603-898-1617
Mailing Address - Fax:
Practice Address - Street 1:150 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-1713
Practice Address - Country:US
Practice Address - Phone:800-495-0086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2125101YM0800X
MA5572101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5572OtherLMHC