Provider Demographics
NPI:1952942476
Name:HOLTON, EMILY J (LPCC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:J
Last Name:HOLTON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 E THOMAS RD APT 1104
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-2106
Mailing Address - Country:US
Mailing Address - Phone:612-465-9011
Mailing Address - Fax:
Practice Address - Street 1:3425 E THOMAS RD APT 1104
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-2106
Practice Address - Country:US
Practice Address - Phone:612-465-9011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-06
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health