MEDICARE: CHRISTINE NICHOLE HOLDEN QMHP

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	175T00000X	Peer Specialist
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1972461143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE NICHOLE HOLDEN QMHP

Provider Business Mailing Address
First Line	:	1800 WILLIAMSBURG RD APT 22E
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-3544
Country	:	US
Telephone Number	:	919-729-1798
Fax Number	:	919-714-0918

Provider Business Practice Location Address
First Line	:	109 JOLLY ST
Second Line	:
City	:	LOUISBURG
State	:	NC
Zip	:	27549-2239
Country	:	US
Telephone Number	:	919-729-1708
Fax Number	:	919-714-0918

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

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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