Provider Demographics
NPI:1699500835
Name:HOLMES, MCKENZIE RENEE
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:RENEE
Last Name:HOLMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 W MOREHEAD ST UNIT 171
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3196
Mailing Address - Country:US
Mailing Address - Phone:813-400-4298
Mailing Address - Fax:
Practice Address - Street 1:5950 FAIRVIEW RD STE 770
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3142
Practice Address - Country:US
Practice Address - Phone:704-457-7834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor