Provider Demographics
NPI:1144015660
Name:HOLCOMBE, MICHELE
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:HOLCOMBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 MANHATTAN AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-4057
Mailing Address - Country:US
Mailing Address - Phone:443-386-5746
Mailing Address - Fax:
Practice Address - Street 1:3100 LORD BALTIMORE DR STE 110
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-5804
Practice Address - Country:US
Practice Address - Phone:410-844-0770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP16274101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health