Healthcare Provider Details

I. General information

NPI: 1881946648
Provider Name (Legal Business Name): HAROLD E. HOLCOMB LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2012
Last Update Date: 02/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 FORD AVE
OWENSBORO KY
42301-4677
US

IV. Provider business mailing address

PO BOX 23229
OWENSBORO KY
42304-3229
US

V. Phone/Fax

Practice location:
  • Phone: 270-688-4845
  • Fax: 270-688-4811
Mailing address:
  • Phone: 270-691-8070
  • Fax: 270-691-8026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number172342
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: