Provider Demographics
NPI:1306683578
Name:HOLDEN, CARRIE EDITH (LPC-MH SUPERVISEE)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:EDITH
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:LPC-MH SUPERVISEE
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:EDITH
Other - Last Name:HOLDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC-MH SUPERVISEE
Mailing Address - Street 1:421 32ND ST NW
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-5872
Mailing Address - Country:US
Mailing Address - Phone:605-880-9281
Mailing Address - Fax:
Practice Address - Street 1:421 32ND ST NW
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-5872
Practice Address - Country:US
Practice Address - Phone:605-880-9281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD30912101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health