Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Anjuli Dominique Holmes

Individual provider Professional Counselor · NPI 1609648641

Anjuli Dominique Holmes is a Mental Health Counselor in Kenosha, Wisconsin. Qualified in 2023, 3 years ago. Practices with Professional Services Group Inc, a 22-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
3
Licensed in
WI
In the registry since
2023
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2108 63rd St
Kenosha, WI 53143-4454
Phone: (262) 652-2406
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 11710-125 (WI)
Counselor Taxonomy 101Y00000X · Licence 7641-226 (WI)

Record details

NPI number1609648641
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 24, 2023
Last updated in NPPESApril 16, 2025
Certification dateApril 16, 2025
Mailing address6233 39th Ave, Kenosha, WI 53142-7015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Professional Services Group Inc. — 22 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Kenosha