Healthcare Provider Details

I. General information

NPI: 1023124559
Provider Name (Legal Business Name): DAN HOLMES PH.D., LPC, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2912 KING ST
JONESBORO AR
72401-5321
US

IV. Provider business mailing address

2912 KING ST
JONESBORO AR
72401-5321
US

V. Phone/Fax

Practice location:
  • Phone: 870-910-3757
  • Fax: 870-910-4999
Mailing address:
  • Phone: 870-910-3757
  • Fax: 870-910-4999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP9605014
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM9805025
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: