Provider Demographics
NPI:1053983072
Name:HOLDEN, ERIN MACKENZIE (LADC, CCS)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MACKENZIE
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:LADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 BERAKA VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CASCO
Mailing Address - State:ME
Mailing Address - Zip Code:04015-4161
Mailing Address - Country:US
Mailing Address - Phone:207-595-6854
Mailing Address - Fax:
Practice Address - Street 1:34 BERAKA VALLEY RD
Practice Address - Street 2:
Practice Address - City:CASCO
Practice Address - State:ME
Practice Address - Zip Code:04015-4161
Practice Address - Country:US
Practice Address - Phone:207-595-6854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty