Holt, Tom G
Holt, Tom G is an sole proprietor health care provider with primary practice located at W156N8327 Pilgrim Rd Ste 302 , Menomonee Falls WI 53051-3776. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Holt, Tom G can be contacted via phone (262) 251-1112.Contact Information
Primary practice address
W156N8327 Pilgrim Rd Ste 302
Menomonee Falls WI 53051-3776
Phone: (262) 251-1112
Fax: (262) 251-1113
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 505 | Wisconsin |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 1242308 | Wisconsin |
Profile Details
| NPI number | 1487733762 |
|---|---|
| LBN Legal business name | Holt, Tom G |
| Credentials | LPC LMFT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 6th, 2006 |
| Last updated | Nov 14th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487733762 | NPPES |
| Wisconsin | MEDICAID | 39607200 |
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