Provider Demographics
NPI:1760284228
Name:HOLMES, ANGELA (MSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:HOLMES
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 PAYSON RD
Mailing Address - Street 2:
Mailing Address - City:BROOKS
Mailing Address - State:ME
Mailing Address - Zip Code:04921-3700
Mailing Address - Country:US
Mailing Address - Phone:207-542-4524
Mailing Address - Fax:
Practice Address - Street 1:49 PAYSON RD
Practice Address - Street 2:
Practice Address - City:BROOKS
Practice Address - State:ME
Practice Address - Zip Code:04921-3700
Practice Address - Country:US
Practice Address - Phone:207-542-4524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical