Provider Demographics
NPI:1962741009
Name:HOLT, CELESTINE MARIE (PMHNP)
Entity type:Individual
Prefix:MS
First Name:CELESTINE
Middle Name:MARIE
Last Name:HOLT
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MRS
Other - First Name:CELESTINE
Other - Middle Name:MARIE
Other - Last Name:HOLT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP
Mailing Address - Street 1:332 BIRNIE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1104
Mailing Address - Country:US
Mailing Address - Phone:413-733-6624
Mailing Address - Fax:
Practice Address - Street 1:332 BIRNIE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1104
Practice Address - Country:US
Practice Address - Phone:413-733-6624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-09
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA182841363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health