=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336328731
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET HOLT LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2007
-----------------------------------------------------
Last Update Date | 01/05/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3822 N HIGHWAY 7 SUITE 5
-----------------------------------------------------
City | HOT SPRINGS VILLAGE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71909-9605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-538-4596
-----------------------------------------------------
Fax | 501-318-0774
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 44 TOLEDO DR
-----------------------------------------------------
City | HOT SPRINGS VILLAGE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71909-2856
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-538-4596
-----------------------------------------------------
Fax | 501-318-0774
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 11424
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------