Provider Demographics
NPI:1770720328
Name:HOLMES, JAMES (LCSW-C)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HOLMES
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:6318 DEMOCRACY BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1664
Mailing Address - Country:US
Mailing Address - Phone:301-461-5953
Mailing Address - Fax:
Practice Address - Street 1:6318 DEMOCRACY BLVD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1664
Practice Address - Country:US
Practice Address - Phone:301-461-5953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-18
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD045981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical