Provider Demographics
NPI:1851186563
Name:HOLMES, RENA SHARON (MSW, LGSW)
Entity type:Individual
Prefix:
First Name:RENA
Middle Name:SHARON
Last Name:HOLMES
Suffix:
Gender:
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 W ARROWHEAD RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-4241
Mailing Address - Country:US
Mailing Address - Phone:651-767-2660
Mailing Address - Fax:
Practice Address - Street 1:615 PECAN AVE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-2749
Practice Address - Country:US
Practice Address - Phone:651-767-2660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN338751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical