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NPI 1790173631

NPI 1790173631 : EMILY HOLT LPCC, LPAT, CADC : CRESTWOOD, KY

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General NPI Number Information
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    NPI Number           |    1790173631
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    Entity Type          |    Individual 
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    Provider Name        |    EMILY HOLT LPCC, LPAT, CADC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/30/2014
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    Last Update Date     |    09/02/2022
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Provider Practice Location Address
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    Address Line         |    1001 CORNELL CT 
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    City                 |    CRESTWOOD
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    State                |    KY
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    Zip                  |    40014-9679
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    Country              |    US
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    Telephone            |    502-905-7714
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1001 CORNELL CT 
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    City                 |    CRESTWOOD
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    State                |    KY
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    Zip                  |    40014-9679
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    Country              |    US
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    Telephone            |    502-905-7714
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    Fax                  |    
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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       |    103551
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    License Number State |    KY
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Taxonomy #2
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    Taxonomy Code        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    KY-0015
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    License Number State |    KY
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