MEDICARE: CHRISTINE HOLMFELT 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

General Provider Information

NPI Number	:	1548808033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTINE HOLMFELT LCSW

Provider Business Mailing Address
First Line	:	PO BOX 3652
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81502-3652
Country	:	US
Telephone Number	:	970-697-4831
Fax Number	:	970-549-0017

Provider Business Practice Location Address
First Line	:	1211 COLORADO AVE
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-4630
Country	:	US
Telephone Number	:	970-697-4831
Fax Number	:	970-549-0017

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTINE C HOLMFELT
Credential	:	LCSW
Telephone Number	:	970-697-4831

Provider Enumeration Date	:	12/15/2019
Last Update Date	:	01/20/2020

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