Individual provider Active NPI

Faith Michele Holston

  • Professional Counselor
  • Atlanta, GA
National Provider Identifier
1003514423
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
APC009729 Issued in GA
Practice address
1030 Fayetteville Rd SE
Atlanta, GA 30316-2921
Phone
(404) 486-9034
NPI assigned
Feb 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X APC009729 GA Primary

Addresses

Primary practice location

1030 Fayetteville Rd SE
Atlanta, GA 30316-2921

Mailing address

1030 Fayetteville Rd SE
Atlanta, GA 30316-2921
Phone (404) 486-9034

Other practice location 1

200 Westpark Dr Ste 120
Peachtree City, GA 30269-1447
Phone (678) 679-9796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260529002272 GA Practitioner - Mental Health Counselor 4688144777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

803 Sunken Rd
Fredericksburg, VA 22401-5401

PO Box
Atlanta, GA 30374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APC009729GAMDProfessional Counselor

Networks

  • AL HMO
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • AL HMO D-SNP
  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • FL HMO D-SNP
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • TN PPO C-SNP
  • FL HMO
  • FL HMO C-SNP
  • TN PPO

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1003514423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 FAYETTEVILLE RD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162921",
            "telephone_number": "404-486-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 FAYETTEVILLE RD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162921",
            "telephone_number": "404-486-9034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Westpark Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302691447",
            "country_code": "US",
            "telephone_number": "678-679-9796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLSTON",
        "first_name": "FAITH",
        "middle_name": "MICHELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-16",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC009729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.