Active NPI
Bonnie Danson Holstein Sr., PSY.D.
- Clinical Psychologist
- Ashland, OR
National Provider Identifier
1023032836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1783
- Practice address
- 208 Oak St
Suite 102
Ashland, OR 97520-1871 - Phone
- (541) 292-7536
- NPI assigned
- Jul 26, 2006
- Last updated
- Apr 4, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1783 | OR | Primary |
Addresses
Primary practice location
208 Oak St
Suite 102
Ashland, OR 97520-1871
Mailing address
2164 Birchwood LN
Ashland, OR 97520-1465
Phone (541) 292-7536
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R140780 | Other | OR | PTAN NUMBER FOR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080306000160 | OR | Practitioner - Clinical Psychologist | 5496759664 | Practice locations: Ashland, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
208 Oak St
Suite 112
Ashland, OR 97520-1870
Phone (541) 292-7536
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1783 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207267200000",
"number": "1023032836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2164 BIRCHWOOD LN",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975201465",
"telephone_number": "541-292-7536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 OAK ST",
"address_2": "SUITE 102",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975201871",
"telephone_number": "541-292-7536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLSTEIN",
"first_name": "BONNIE",
"middle_name": "DANSON",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2008-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1783",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN NUMBER FOR MEDICARE",
"identifier": "R140780",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.