MEDICARE: EMILY ANN HOLMES LPCA

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	101YP2500X	Professional Counselor	A10408	NC

General Provider Information

NPI Number	:	1932608445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ANN HOLMES LPCA

Provider Business Mailing Address
First Line	:	2305 LAWNDALE DR
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27408-6225
Country	:	US
Telephone Number	:	410-200-1287
Fax Number	:

Provider Business Practice Location Address
First Line	:	815 W MARKET ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-1823
Country	:	US
Telephone Number	:	336-272-7102
Fax Number	:

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

Provider Enumeration Date	:	02/09/2018
Last Update Date	:	03/17/2018

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