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NPI Code Detail

MEDICARE: NACOLE MARIETTA HOLMES

MEDICARE: NACOLE MARIETTA HOLMES
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
1101YM0800XMental Health CounselorLW61544692WA
21041C0700XClinical Social WorkerLW61544692WA
3104100000XSocial WorkerLW61544692WA

General Provider Information

NPI Number : 1972032449
Entity Type Code : Individual
Provider Name (Legal Business Name) : NACOLE MARIETTA HOLMES
Provider Business Mailing Address
First Line : 1057 12TH AVE
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-2509
Country : US
Telephone Number : 360-998-2349
Fax Number : 360-998-2887
Provider Business Practice Location Address
First Line : 831 12TH AVE
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-2403
Country : US
Telephone Number : 360-998-2349
Fax Number : 360-998-2887
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2017
Last Update Date : 06/15/2026

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Directions to “ NACOLE MARIETTA HOLMES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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