Provider Demographics
NPI:1992271522
Name:HOLMES, ERICA P (EDD, LPC)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:P
Last Name:HOLMES
Suffix:
Gender:F
Credentials:EDD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7145 SWINNEA RD STE 2
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-6380
Mailing Address - Country:US
Mailing Address - Phone:901-647-9167
Mailing Address - Fax:
Practice Address - Street 1:7145 SWINNEA RD STE 2
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-6380
Practice Address - Country:US
Practice Address - Phone:901-647-9167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2022-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP-0109101Y00000X
MS2554101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor