Bradley W & Lisa C Holder
Organization Active NPI Professional Counselor · North Port, FL
NPI 1497609291 · NPPES record last updated Feb 26, 2026
Key facts
- NPI
- 1497609291
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Professional Counselor 101YP2500X
- Legal business name
- BRADLEY W & LISA C HOLDER
- Practice address
- 3310 Delor Ave
North Port, FL 34286-7102 - Phone
- (719) 492-1317
- NPI assigned
- Feb 26, 2026
- Organization subpart
- No
Authorized official
- Name
- Lisa C Holder
- Title
- Onwer
- Phone
- (719) 492-1317
Practitioners 1
-
Lisa Carol Holder, PHD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20260409001065 | FL | Part B Supplier - Clinic/Group Practice | 8022583822 |
Receives reassigned benefits from 1 practitioner Practice locations: North Port, FL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | Yes |
Addresses
Primary practice location
3310 Delor Ave
North Port, FL 34286-7102
Mailing address
3310 Delor Ave
North Port, FL 34286-7102
Other providers in North Port, FL
- Christiana Bostic
- Claudine E. Bowie
- Audra Boxma
- Angela Boyle
- Sarah Bracken
- Sabrina Bradley
- Dominique Brailsford
- Jadyn Bramble
- Jessica Braundmeier
- Erica Brewer
All providers in North Port, FL · Professional Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.