Provider Demographics
NPI:1891824660
Name:HOLTBY, MICHAEL EARLE (MSW, LCSW, BCD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:EARLE
Last Name:HOLTBY
Suffix:
Gender:M
Credentials:MSW, LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 CHEROKEE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-1105
Mailing Address - Country:US
Mailing Address - Phone:303-722-1021
Mailing Address - Fax:303-722-5420
Practice Address - Street 1:309 CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-1105
Practice Address - Country:US
Practice Address - Phone:303-722-1021
Practice Address - Fax:303-722-5420
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9780211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical