Healthcare Provider Details
I. General information
NPI: 1669519070
Provider Name (Legal Business Name): REBECCA M HOLMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/01/2007
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1450 E 10TH ST
ROLLA MO
65401-3648
US
IV. Provider business mailing address
1800 COMMUNITY
CLINTON MO
64735-8804
US
V. Phone/Fax
- Phone: 844-853-8937
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 6942-C |
| License Number State | AR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 2005039215 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: