Jacqueline Holmes, LCSW, PIP
Individual provider Active NPI Clinical Social Worker · Harvest, AL
NPI 1740665462 · NPPES record last updated Jul 23, 2015
Key facts
- NPI
- 1740665462
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 1181-1921C (AL)
- Practice address
- 121 Wilder Dr
Harvest, AL 35749-8270 - Phone
- (256) 653-4902
- NPI assigned
- Jul 23, 2015
- 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 |
|---|---|---|---|
| 1181-1921C | AL | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1181-1921C | AL | Yes |
Addresses
Primary practice location
121 Wilder Dr
Harvest, AL 35749-8270
Mailing address
121 Wilder Dr
Harvest, AL 35749-8270
Phone (256) 653-4902
Other providers in Harvest, AL
- Amanda Lee Hays
- Healthsource of Harvest
- Felicia Latoya Hill
- Pamela Hill
- Sheila Vanell Hill
- Charles Donovan Hooper
- Jessica Danielle Hughley
- Marcus Daniel Hulsey
- J & S Homes, Inc.
- Destiny Jackson
All providers in Harvest, AL · Clinical Social Worker in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2015. 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.