| Doctor Name: | MR. JOHN RICHARD HOLMES |
| NPI Number: | 1174828354 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW-R |
| License Number: | 072549 |
| Business Practice Address: | 7403 Commonwealth Blvd Bellerose, NY - 114261839 |
| Business Phone Number: | 7182644578 |
| Business Fax Number: | 7182644939 |
| Mailing Address: | 6364 77th Pl, MIDDLE VILLAGE |
| State: | NY |
| Postal Code: | 113791306 |
| Phone Number: | 7183261436 |
| Fax Number: | |
| NPI Enumeration Date: | 01/19/2011 |
| NPI Last Update Date: | 01/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 072549 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |