Provider Demographics
NPI:1215331590
Name:HOLMON, BIANCO (MSW, LCSW, LCAS-A)
Entity type:Individual
Prefix:
First Name:BIANCO
Middle Name:
Last Name:HOLMON
Suffix:
Gender:F
Credentials:MSW, LCSW, LCAS-A
Other - Prefix:
Other - First Name:BIANCO
Other - Middle Name:DEE
Other - Last Name:HOLMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 542
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-0542
Mailing Address - Country:US
Mailing Address - Phone:910-273-9956
Mailing Address - Fax:
Practice Address - Street 1:3674 PIONEER DR
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-9346
Practice Address - Country:US
Practice Address - Phone:910-273-9956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-15
Last Update Date:2016-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-20884101YA0400X
NCC0105111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)