Healthcare Provider Details

I. General information

NPI: 1912856873
Provider Name (Legal Business Name): JULIE ANN HOLMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2026
Last Update Date: 01/24/2026
Certification Date: 01/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6639 CENTURION DR STE 200
LANSING MI
48917-8273
US

IV. Provider business mailing address

3420 W SAGINAW ST
LANSING MI
48917-2203
US

V. Phone/Fax

Practice location:
  • Phone: 231-201-6565
  • Fax:
Mailing address:
  • Phone: 517-358-0663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451024734
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: