Provider Demographics
NPI:1427459155
Name:HOLDER, TARMARA EUKERA (LCSW CAADC)
Entity type:Individual
Prefix:
First Name:TARMARA
Middle Name:EUKERA
Last Name:HOLDER
Suffix:
Gender:F
Credentials:LCSW CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:749 POINTE WEST LOOP
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-0912
Mailing Address - Country:US
Mailing Address - Phone:478-697-1983
Mailing Address - Fax:478-296-2110
Practice Address - Street 1:749 POINTE WEST LOOP
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-0912
Practice Address - Country:US
Practice Address - Phone:478-697-1983
Practice Address - Fax:478-296-2110
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW005217101YM0800X, 101YP2500X, 103K00000X, 1041C0700X, 106H00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)