MEDICARE: KAITLIN MARIE HOLT LMHC

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	39005301A	IN

General Provider Information

NPI Number	:	1538973441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLIN MARIE HOLT LMHC

Provider Business Mailing Address
First Line	:	8320 MADISON AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-6066
Country	:	US
Telephone Number	:	317-882-5122
Fax Number	:

Provider Business Practice Location Address
First Line	:	8404 SIEAR TER STE 100
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-7201
Country	:	US
Telephone Number	:	317-882-5122
Fax Number	:

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

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	03/12/2025

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