Basom, Holly Erin

Basom, Holly Erin is an individual health care provider with primary practice located at 1430 Olive St Ste 400 , Saint Louis MO 63103-2303. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Basom, Holly Erin can be contacted via phone (314) 206-3700.

Contact Information

Primary practice address
1430 Olive St Ste 400 Saint Louis MO 63103-2303
Phone: (314) 206-3700
Fax: (314) 206-3708
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2014012314 Missouri

Profile Details

NPI number 1881740892
LBN Legal business name Basom, Holly Erin
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2007
Last updated Nov 29th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881740892 NPPES
Missouri Other 2014012314 LPC

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