Provider Demographics
NPI:1689466963
Name:HOLTE, BRADEN (LAC)
Entity type:Individual
Prefix:
First Name:BRADEN
Middle Name:
Last Name:HOLTE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N BROADWAY STE 111
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58703-2378
Mailing Address - Country:US
Mailing Address - Phone:701-537-4191
Mailing Address - Fax:701-537-4191
Practice Address - Street 1:900 N BROADWAY STE 111
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703-2378
Practice Address - Country:US
Practice Address - Phone:701-537-4191
Practice Address - Fax:701-537-4191
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2017101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)