Provider Demographics
NPI:1861962706
Name:HOLFELTZ, JESSICA LUDLOW (CMHC, LPC-MHSP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LUDLOW
Last Name:HOLFELTZ
Suffix:
Gender:F
Credentials:CMHC, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 E DRAPER PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9077
Mailing Address - Country:US
Mailing Address - Phone:801-915-3882
Mailing Address - Fax:
Practice Address - Street 1:1111 E DRAPER PKWY STE 103
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9077
Practice Address - Country:US
Practice Address - Phone:801-915-3882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10324404-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health