Basic Information
Provider Information
NPI: 1396978771
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOLMES
FirstName: MELANIE
MiddleName: JEANNE
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1316 PATTON AVE STE D
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288062652
CountryCode: US
TelephoneNumber: 8287778120
FaxNumber: 8282253604
Practice Location
Address1: 1316 PATTON AVE STE D
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288062652
CountryCode: US
TelephoneNumber: 8287778120
FaxNumber: 8282253604
Other Information
ProviderEnumerationDate: 09/01/2009
LastUpdateDate: 03/22/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XC006749NCY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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