Provider Demographics
NPI:1871787853
Name:HOLT, PATTI SUZANNE (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:PATTI
Middle Name:SUZANNE
Last Name:HOLT
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:PATTI
Other - Middle Name:SUZANNE
Other - Last Name:CAPARROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5350 N ACADEMY BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4055
Mailing Address - Country:US
Mailing Address - Phone:719-321-4497
Mailing Address - Fax:
Practice Address - Street 1:5350 N ACADEMY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4055
Practice Address - Country:US
Practice Address - Phone:719-321-4497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3357101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional