Individual provider Active NPI

Holly Numan, LPC, SAC-IT

  • Mental Health Counselor
  • Waukesha, WI
National Provider Identifier
1043924293
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10758-125 Issued in WI
Practice address
514 Riverview Ave
Waukesha, WI 53188-3631
Phone
(262) 548-7973
NPI assigned
Jan 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 19696-130 WI
Mental Health Counselor 101YM0800X 5223-226 WI
Mental Health Counselor 101YM0800X 10758-125 WI Primary

Addresses

Primary practice location

514 Riverview Ave
Waukesha, WI 53188-3631

Mailing address

514 Riverview Ave
Waukesha, WI 53188-3631
Phone (262) 548-7973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20240229002916 WI Practitioner - Mental Health Counselor 4880039890 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19696-130WIMDAddiction (Substance Use Disorder) Counselor
10758-125WIMDMental Health Counselor
5223-226WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Waukesha County Current Accepting new patients
Waukesha County CurrentSince Jan 1, 2024 Accepting new patients
Waukesha County CurrentSince Jan 1, 2024 Accepting new patients

Locations

1501 Airport Rd
Waukesha, WI 53188
Phone (262) 548-7950

514 Riverview Ave
Waukesha, WI 53188
Phone (262) 548-7212

Organizations & group practices 3

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": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1043924293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 RIVERVIEW AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883631",
            "telephone_number": "262-548-7973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 RIVERVIEW AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883631",
            "telephone_number": "262-548-7973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUMAN",
        "first_name": "HOLLY",
        "credential": "LPC, SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "19696-130",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "5223-226",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "10758-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.