MEDICARE: DEMARIE A HOLMES LCSW

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	1041C0700X	Clinical Social Worker	LCSW-20633	AZ

General Provider Information

NPI Number	:	1477191880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEMARIE A HOLMES LCSW

Provider Business Mailing Address
First Line	:	2534 E LESTER ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-3039
Country	:	US
Telephone Number	:	623-806-2239
Fax Number	:

Provider Business Practice Location Address
First Line	:	6303 E TANQUE VERDE RD STE 210
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85715-3859
Country	:	US
Telephone Number	:	520-896-1400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2019
Last Update Date	:	05/05/2026

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