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NPI Code Detail

MEDICARE: KASONDRA HOLTZ LMSW

MEDICARE:   KASONDRA  HOLTZ  LMSW
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
11041C0700XClinical Social Worker6801109323MI

General Provider Information

NPI Number : 1700733789
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASONDRA HOLTZ LMSW
Provider Business Mailing Address
First Line : 3415 TIMBERVIEW TRL
Second Line :
City : LAPEER
State : MI
Zip : 48446-8733
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3415 TIMBERVIEW TRL
Second Line :
City : LAPEER
State : MI
Zip : 48446-8733
Country : US
Telephone Number : 810-250-3539
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2026
Last Update Date : 03/11/2026

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Directions to “ KASONDRA HOLTZ LMSW” Practice Location

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