Healthcare Provider Details

I. General information

NPI: 1083520050
Provider Name (Legal Business Name): LAUREN KRISTEN HOLMES LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 SHORT ST
KINGSTREE SC
29556-3927
US

IV. Provider business mailing address

PO BOX 1204
KINGSTREE SC
29556-1204
US

V. Phone/Fax

Practice location:
  • Phone: 843-244-0743
  • Fax:
Mailing address:
  • Phone: 843-244-0743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11119
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: