Individual
CHARISSE NIRVANNA HOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
144 HILLSIDE DR, GEORGETOWN, KY 40324-2114
(804) 651-0116
(804) 651-0116
Mailing address
144 HILLSIDE DR, GEORGETOWN, KY 40324-2114
(804) 651-0116
(804) 651-0116
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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