Gwendolyn Lee Holder, LCADC, LPCA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

270741 Issued in KY

Practice address

108 12TH St
Clay City, KY 40312-8979

Phone

(606) 663-9011

NPI assigned

Jul 19, 2021

Last updated

Jul 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kentucky River Foothills Development Council, Inc.

  dba Foothills Health and Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Clay City, KY
  • NPI 1366713000
  NPD
• Kentucky River Foothills Development Council, Inc.

  dba Foothills Behavioral Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Irvine, KY
  • NPI 1346874054
  NPD (past)
• New Vista of the Bluegrass Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lexington, KY
  • NPI 1023359783
  NPD (past)

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1891368916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 CURTIS PIKE",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404759794",
            "telephone_number": "859-314-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 12TH ST",
            "city": "CLAY CITY",
            "state": "KY",
            "postal_code": "403128979",
            "telephone_number": "606-663-9011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Tyler Ln",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "KY",
            "postal_code": "403368827",
            "country_code": "US",
            "telephone_number": "606-531-2012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "GWENDOLYN",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LCADC, LPCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "270741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creekside Child Development Services Inc
• Sandra Crum-Stevens, DMD
• Lelia Elam, R.D.
• Felicia Estes, APRN, FNP-BC
• Sasha Flinchum
• Jordan Drug, Inc. (Powell Prescription Center)
• Julie Renee Kennon, M.D.
• Kentucky River Foothills Development Council, Inc. (Foothills Health and Wellness Center)
• Kentucky River Foothills Development Council, Inc.
• Kentucky River Foothills Development Council, Inc.

• Professional Counselor in Clay City, KY
• Providers in Clay City, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.