Provider Demographics
NPI:1932525789
Name:HOLDERNESS, STEVE III (EDS)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:
Last Name:HOLDERNESS
Suffix:III
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1889 ASHLEY HALL RD.
Mailing Address - Street 2:
Mailing Address - City:CHARLESOTN
Mailing Address - State:SC
Mailing Address - Zip Code:29407
Mailing Address - Country:US
Mailing Address - Phone:843-556-2156
Mailing Address - Fax:
Practice Address - Street 1:611 COLLETON LOOP
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488
Practice Address - Country:US
Practice Address - Phone:843-782-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool