NPIMap

Organization Active NPI

Holistic Counseling Services, LLC

  • Professional Counselor
  • Beloit, WI
National Provider Identifier
1033773734
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
HOLISTIC COUNSELING SERVICES, LLC
Practice address
1517 Huebbe Parkway
Ste a
Beloit, WI 53511
Phone
(608) 291-5891
Fax
(608) 713-9040
NPI assigned
Apr 28, 2019
Last updated
Apr 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Authorized official

Name
Jackie Lynn Miller, LPCNPI 1922549567
Title
Owner
Phone
(608) 291-5891

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

1517 Huebbe Parkway
Ste a
Beloit, WI 53511

Mailing address

1517 E Huebbe Pkwy Ste a
Beloit, WI 53511-1795
Phone (608) 291-5891

Other identifiers 1

IdentifierTypeStateIssuer
100096899MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220325001452 WI Part B Supplier - Clinic/Group Practice 4880089085 Receives reassigned benefits from 1 practitioner
Practice locations: Beloit, WI

National Provider Directory

National Provider Directory

Locations

1517 E Huebbe Pkwy
Ste A
Beloit, WI 53511
Phone (608) 291-5891

816 4th St
Ste 203
Beloit, WI 53511

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1556409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586390400000",
    "number": "1033773734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 E HUEBBE PKWY STE A",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111795",
            "telephone_number": "608-291-5891",
            "fax_number": "608-713-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 HUEBBE PARKWAY",
            "address_2": "STE A",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "53511",
            "telephone_number": "608-291-5891",
            "fax_number": "608-713-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-28",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-291-5891",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100096899",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.