Kenneth James Holt, LISW-S, LICDC

NPI #1174974117 in Mentor, Ohio

Provider Information

NPI Number: 1174974117
Entity Type: Individual
Name: Kenneth James Holt, LISW-S, LICDC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: LISW-S, LICDC
Enumeration Date: Jun 30, 2016
Last Updated: Mar 28, 2021

Practice Location

Address: 7232 JUSTIN WAY
City: Mentor
State: Ohio
ZIP Code: 44060-4881
Phone: (440) 578-8200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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