MR. REGINALD WYNN HOLT (NPI# 1487602827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487602827 |
| Entity Type | Individual |
| Full Name | MR. REGINALD WYNN HOLT |
| Credential | MA, LCPC, LPC, CADC |
| Practice Address |
6201 W Main St Suite 110 Maryville IL 62062-6870 |
| Mailing Address |
1824 Rutger St Saint Louis MO 63104-2944 |
| Practice Telephone | 6163436230 |
| Practice Fax Number | 6183436235 |
| Mailing Telephone | 3146211334 |
| Mailing Fax Number | 6183436235 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
18612 | IL | Behavioral Health & Social Service Providers |
| X | 101YM0800X |
Counselor Specialization: Mental Health |
IL | Behavioral Health & Social Service Providers | |
| X | 101YP2500X |
Counselor Specialization: Professional |
IL | Behavioral Health & Social Service Providers |
| Street Address |
6201 W MAIN ST SUITE 110 |
| City | MARYVILLE |
| State | IL |
| Zip Code | 62062-6870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891330585 | Rachel Kent | Counselor | 6201 W Main St, Maryville, IL 62062-6870 | 2019-11-17 |
| 1487195582 | Midwestern Psychological Consultants, Ltd | Psychologist | 6201 W Main St, Suite 130, Maryville, IL 62062-6870 | 2017-03-09 |
| 1174962419 | Stephanie A Henson | Social Worker | 6201 W Main St, Suite 130, Maryville, IL 62062-6870 | 2013-06-20 |
| 1902161730 | William Schwartz | Counselor | 6201 W Main St, Suite 110, Maryville, IL 62062-6870 | 2012-07-09 |
| 1912274374 | Anne Rappaport | Counselor | 6201 W Main St, Suite 110, Maryville, IL 62062-6870 | 2011-11-29 |
| 1528103108 | Robin L. Myers | Psychologist | 6201 W Main St, Ste 130, Maryville, IL 62062-6870 | 2007-02-21 |
| 1245247600 | Melissa S Jordan-murphy | Counselor | 6201 W Main St, Suite110, Maryville, IL 62062-6870 | 2006-08-01 |
| 1720009889 | Nancy Jane Bracey | Counselor | 6201 W Main St, Suite 110, Maryville, IL 62062-6870 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
| 1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
| Find all providers in zip 62062 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598250359 | Patricia Lynn Wharton | Counselor | 547 W Lamar Alexander Pkwy, Maryville, TN 37801-4760 | 2018-06-25 |
| 1083157085 | Zachary Charles Talbott | Counselor | 1821 W Broadway Ave, Maryville, TN 37801-5511 | 2016-11-22 |
| 1619315603 | William Sean Prescott | Counselor | 318 North Main, Maryville, MO 64468 | 2013-06-12 |
| 1093076655 | Julie Ann Sutter | Counselor | 200 E Broadway Ave Ste 413, Maryville, TN 37804-5754 | 2012-05-30 |
| 1124534912 | Extasy Grinn | Counselor | 2030 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2017-12-16 |
| 1144750605 | Rebecca Leigh Salah | Counselor | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2017-06-18 |
| 1497115315 | Kolin Smith | Counselor | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2016-03-04 |
| 1336521947 | Kevin Robertson | Counselor | 318 N Main St, Maryville, MO 64468-1644 | 2015-06-19 |
| 1336578442 | New Beginnings Counseling Group | Counselor | 423 N Market St, Maryville, MO 64468 | 2013-11-08 |
| 1750719142 | Courtney L Hupp | Counselor | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2013-10-22 |
| Find all providers in MARYVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.