Provider Demographics
NPI:1174552442
Name:HOLDEN, WILLIAM DAVID (LPC, LCAS)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DAVID
Last Name:HOLDEN
Suffix:
Gender:M
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1656
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-1656
Mailing Address - Country:US
Mailing Address - Phone:336-838-1644
Mailing Address - Fax:336-667-7720
Practice Address - Street 1:204 JEFFERSON STREET, SUITE 106
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3586
Practice Address - Country:US
Practice Address - Phone:336-838-1644
Practice Address - Fax:336-667-7720
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLPC #2749101YP2500X
NCLCAS # 147101YA0400X
NCMHL-095-033261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1022POtherBCBSNC