Provider Demographics
NPI:1154889921
Name:HOLT, LOUIS ANTHONY (MSS, BA)
Entity type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:ANTHONY
Last Name:HOLT
Suffix:
Gender:M
Credentials:MSS, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 CANAL ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6249
Mailing Address - Country:US
Mailing Address - Phone:504-644-2575
Mailing Address - Fax:504-644-2803
Practice Address - Street 1:3301 CANAL ST APT 1
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6249
Practice Address - Country:US
Practice Address - Phone:504-644-2575
Practice Address - Fax:504-644-2803
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS801098667Medicaid