MEDICARE: HEATHER LYNN HOLT LLMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	6851121317	MI

General Provider Information

NPI Number	:	1013875970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER LYNN HOLT LLMSW

Provider Business Mailing Address
First Line	:	569 WILDWOOD AVE UNIT 4
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-1048
Country	:	US
Telephone Number	:	517-726-6765
Fax Number	:

Provider Business Practice Location Address
First Line	:	569 WILDWOOD AVE UNIT 4
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-1048
Country	:	US
Telephone Number	:	517-726-6765
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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