MR. REGINALD WYNN HOLT MA LCPC LPC CADC NPI 1487602827

NPI Information

  • NPI: 1487602827
  • Provider Name: MR. REGINALD WYNN HOLT, MA, LCPC, LPC, CADC
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 6201 W MAIN ST
    SUITE 110
    MARYVILLE, IL
    ZIP 62062
  • Phone: (616) 343-6230

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NPI Details

MR. Reginald Wynn Holt, MA, LCPC, LPC, CADC is an addiction (substance use disorder) counselor in Maryville, IL. MR. Reginald Wynn Holt, MA, LCPC, LPC, CADC NPI is 1487602827. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6201 W MAIN ST
SUITE 110
MARYVILLE, IL
ZIP 62062-870
Phone: (616) 343-6230
Fax: (618) 343-6235

The enumeration date for this NPI number is 5/5/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)18612ILLINOISYes
2101YM0800XCounselorMental HealthILLINOISX
3101YP2500XCounselorProfessionalILLINOISX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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