Deadre Renee Holmes, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2011013668 Issued in MO

Practice address

3115 S Grand Blvd Ste 400
Saint Louis, MO 63118-1048

Phone

(314) 449-5639

NPI assigned

Dec 17, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1639577083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 CHURCHILL DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630331510",
            "telephone_number": "314-449-5639",
            "fax_number": "844-682-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 S GRAND BLVD STE 400",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631181048",
            "telephone_number": "314-449-5639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 W Losey St",
            "address_purpose": "LOCATION",
            "city": "Scott AFB",
            "state": "IL",
            "postal_code": "622255252",
            "country_code": "US",
            "telephone_number": "618-256-7386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "DEADRE",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-17",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2011013668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2011013668",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Samuel Holman, PHARM.D.
• Victoria Holman, RN,ANP
• Anthony Holmes
• Briahna Holmes, L.M.T
• Christina Marie Holmes, LPC
• Ebony Holmes
• Jamie A Holmes, LCSW
• Kaitlin Holmes
• Kendra Holmes, RPH
• Latasha Holmes

• Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.