Individual
MR. KURT DAVID HOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW, LADC
Contact information
Practice address
13045 FALCON DR STE 100, BAXTER, MN 56425-4201
(218) 829-9307
Mailing address
13045 FALCON DR STE 100, BAXTER, MN 56425-4201
(218) 829-9307
(218) 829-7649
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
302032
MN
1041C0700X
Clinical Social Worker
Primary
27249
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27249
LICENSED INDEPENDENT CLINICAL SOCIAL WORKER
MN
01
—
302032
LADC LICENSE
MN
Enumeration date
06/08/2014
Last updated
02/12/2021
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