| Jessica Holton, Pllc | |
|
740 Greenville Blvd Se Ste 400-208 Greenville NC 27858-5135 | |
| (252) 987-3039 | |
| Not Available |
| Full Name | Jessica Holton, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 740 Greenville Blvd Se Ste 400-208, Greenville, North Carolina |
| Authorized Official Name and Position | Jessica Denise Holton (CLINICAL SOCIAL WORKER / PRESIDENT) |
| Authorized Official Contact | 2529873039 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Holton, Pllc 740 Greenville Blvd Se Ste 400-208 Greenville NC 27858-5135 Ph: (252) 987-3039 | Jessica Holton, Pllc 740 Greenville Blvd Se Ste 400-208 Greenville NC 27858-5135 Ph: (252) 987-3039 |
| NPI Number | 1164966966 |
|---|---|
| Provider Enumeration Date | 12/13/2016 |
| Last Update Date | 10/26/2022 |
| Certification Date | 10/26/2022 |
| Medicare PECOS PAC ID | 5799065314 |
|---|---|
| Medicare Enrollment ID | O20161216000930 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164966966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jessica D Holton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780727909 PECOS PAC ID: 3072692714 Enrollment ID: I20080506000400 |
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