Holt, Kenneth James

Holt, Kenneth James is an individual health care provider with primary practice located at 7232 Justin Way , Mentor OH 44060-4881. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Holt, Kenneth James can be contacted via phone (440) 578-8200.

Contact Information

Primary practice address
7232 Justin Way Mentor OH 44060-4881
Phone: (440) 578-8200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X S.1600314 Ohio
Behavioral Health & Social Service Providers / Clinical 1041C0700X I.1801239 Ohio

Profile Details

NPI number 1174974117
LBN Legal business name Holt, Kenneth James
Credentials LISW-S, LICDC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2016
Last updated Mar 28th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174974117 NPPES
Ohio MEDICAID 0266919

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