MEDICARE: ALAINA HOLDER

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	101YM0800X	Mental Health Counselor	39006002A	IN

General Provider Information

NPI Number	:	1689501611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAINA HOLDER

Provider Business Mailing Address
First Line	:	4625 ANGLERS LN
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46808-3508
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7230 ENGLE RD STE 305
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-2227
Country	:	US
Telephone Number	:	260-203-4996
Fax Number	:

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

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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Directions to “ ALAINA HOLDER ” Practice Location

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