Tina Marie Holmes, CRSW
Individual provider Active NPI Community/Behavioral Health Agency · Gorham, NH
NPI 1730729633 · NPPES record last updated Jan 9, 2020
Key facts
- NPI
- 1730729633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 0241 (NH)
- Practice address
- 123 Main St
Gorham, NH 03581-1659 - Phone
- (603) 466-5190
- NPI assigned
- Jan 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0241 | NH | MD | Community/Behavioral Health Agency |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 0241 | NH | Yes |
Addresses
Primary practice location
123 Main St
Gorham, NH 03581-1659
Mailing address
123 Main St
Gorham, NH 03581-1659
Phone (603) 752-2511
Other providers in Gorham, NH
- Gorham Randolph Shelburne Cooperative
- Eric A Hamilton
- Samuel Glenn Hanna
- Mark William Hartzler
- Tung Hoang
- Lindsey Dawn Jackson
- Keene Medical Products, LLC
- Donald Kernan
- Douglas E Knee
- Julie Kaye Limmer
All providers in Gorham, NH · Community/Behavioral Health Agency in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.