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NPI Code Detail

MEDICARE: AMY LYNN HOLDER MS, LPC

MEDICARE: AMY LYNN HOLDER MS, LPC
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
1101Y00000XCounselor7730-125WI
2101Y00000XCounselor
3101YP2500XProfessional Counselor7730-125WI

General Provider Information

NPI Number : 1568732287
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY LYNN HOLDER MS, LPC
Provider Business Mailing Address
First Line : 200 W VERONA AVE
Second Line :
City : VERONA
State : WI
Zip : 53593-1394
Country : US
Telephone Number : 608-218-1496
Fax Number : 608-608-8506
Provider Business Practice Location Address
First Line : 200 W VERONA AVE
Second Line :
City : VERONA
State : WI
Zip : 53593-1394
Country : US
Telephone Number : 608-218-1496
Fax Number : 608-608-8506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2012
Last Update Date : 05/18/2026

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