Individual
MR. DUSTIN E HOLBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW, LICDC-CS
Contact information
Practice address
624 9TH ST, HUNTINGTON, WV 25701
(304) 429-6755
Mailing address
302 FLATWOOD FALLEN TIMBER RD, LUCASVILLE, OH 45648-9051
(740) 352-8201
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
021251
OH
104100000X
Social Worker
1600327
OH
104100000X
Social Worker
I.1801033
OH
1041C0700X
Clinical Social Worker
Primary
I.1801033
OH
Other
Enumeration date
04/18/2007
Last updated
05/08/2019
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