Provider Demographics
NPI:1104649425
Name:HOLDEN, MARK W (MFTT)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:W
Last Name:HOLDEN
Suffix:
Gender:M
Credentials:MFTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 JENNIE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-2138
Mailing Address - Country:US
Mailing Address - Phone:614-681-0926
Mailing Address - Fax:
Practice Address - Street 1:1100 BEECHER XING N STE D
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-4565
Practice Address - Country:US
Practice Address - Phone:614-656-7025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHM.2400379-TRNE106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist