MEDICARE: ELIZABETH SHERWOOD HOLT ATR-BC, 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
1	101Y00000X	Counselor	0701002411	VA
2	221700000X	Art Therapist	88-180	VA

General Provider Information

NPI Number	:	1679773295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH SHERWOOD HOLT ATR-BC, LPC

Provider Business Mailing Address
First Line	:	5477 MOORETOWN RD
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-2108
Country	:	US
Telephone Number	:	757-565-0106
Fax Number	:

Provider Business Practice Location Address
First Line	:	5477 MOORETOWN RD
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-2108
Country	:	US
Telephone Number	:	757-565-0106
Fax Number	:

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

Provider Enumeration Date	:	07/22/2007
Last Update Date	:	07/22/2007

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