Provider Demographics
NPI:1932524774
Name:HOLTMEIER-GUILLIAMS, KYLIE (LCSW, MSW, CCDP)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:
Last Name:HOLTMEIER-GUILLIAMS
Suffix:
Gender:F
Credentials:LCSW, MSW, CCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 BIG BEAR CT
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-3394
Mailing Address - Country:US
Mailing Address - Phone:636-486-5511
Mailing Address - Fax:
Practice Address - Street 1:3505 BIG BEAR CT
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-3394
Practice Address - Country:US
Practice Address - Phone:636-486-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20240154001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical