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NPI Code Detail

MEDICARE: ANTHONY RAY HOLMES LPCC

MEDICARE: ANTHONY RAY HOLMES LPCC
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
1101YP2500XProfessional Counselor1226KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112151069OTHERCAQH
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407121171
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY RAY HOLMES LPCC
Provider Business Mailing Address
First Line : PO BOX 1080
Second Line :
City : BURKESVILLE
State : KY
Zip : 42717-1080
Country : US
Telephone Number : 270-858-6655
Fax Number : 270-858-4607
Provider Business Practice Location Address
First Line : 404 STEVE DRIVE
Second Line :
City : RUSSELL SPRINGS
State : KY
Zip : 42642-4622
Country : US
Telephone Number : 270-866-3161
Fax Number : 270-866-3163
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2012
Last Update Date : 07/13/2023

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