Individual
JONATHAN HOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
119 E CALDERWOOD DR # 102, MERIDIAN, ID 83642-7482
(208) 841-6378
Mailing address
3518 W MORERE DR, MERIDIAN, ID 83642-1147
(208) 841-6378
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
059532
ID
101Y00000X
Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
Primary
4761571
ID
Other
Enumeration date
05/09/2023
Last updated
05/06/2026
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