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General NPI Number Information
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NPI Number | 1376642884
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Entity Type | Individual
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Provider Name | EDGAR JOE HOLT JR. PH.D, LMFT, LPC
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 1117 GEORGIA AVE STE D
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3012
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Country | US
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Telephone | 803-278-4708
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Fax | 803-202-0360
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Provider Business Mailing Address
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Address Line | 1117 GEORGIA AVE STE D
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-6127
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Country | US
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Telephone | 803-752-0404
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Fax | 888-384-2250
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 809
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License Number State | SC
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