Provider Demographics
NPI:1063879591
Name:HOLT, AMY H (LPC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:H
Last Name:HOLT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6413 LEGACY PT
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-6460
Mailing Address - Country:US
Mailing Address - Phone:361-549-3782
Mailing Address - Fax:361-727-2036
Practice Address - Street 1:6413 LEGACY PT
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-6460
Practice Address - Country:US
Practice Address - Phone:361-549-3782
Practice Address - Fax:361-727-2036
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19537101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional