MEDICARE: JULIE HOLDEN LCSW PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	2866C	NV

General Provider Information

NPI Number	:	1043355142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULIE HOLDEN LCSW PC

Provider Business Mailing Address
First Line	:	2921 N TENAYA WAY
Second Line	:	SUITE 107
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1409
Country	:	US
Telephone Number	:	702-947-4899
Fax Number	:	702-396-3169

Provider Business Practice Location Address
First Line	:	2921 N TENAYA WAY
Second Line	:	SUITE 107
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1409
Country	:	US
Telephone Number	:	702-947-4899
Fax Number	:	702-396-3169

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER
Name	:	JULIE A HOLDEN
Credential	:	LCSW
Telephone Number	:	702-947-4899

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	08/22/2020

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