Individual provider Active NPI

Holly Devivo, LMSW-C, LCSW

  • Mental Health Counselor
  • Battle Creek, MI
National Provider Identifier
1063136422
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6851114547 Issued in MI
Practice address
396 S Hills Dr
Battle Creek, MI 49015-3954
Phone
(616) 516-5360
NPI assigned
Sep 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6851114547 MI Primary

Addresses

Primary practice location

396 S Hills Dr
Battle Creek, MI 49015-3954

Mailing address

396 S Hills Dr
Battle Creek, MI 49015-3954
Phone (616) 516-5360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240627003802 MI Practitioner - Clinical Social Worker 9537501770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

332 W Gower Rd
Union City, MI 49094-9439
Phone (269) 262-5546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6851114547MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elevated Therapeutic Services LLC CurrentSince Apr 10, 2024 Accepting new patients

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": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1063136422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 S HILLS DR",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490153954",
            "telephone_number": "616-516-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 S HILLS DR",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490153954",
            "telephone_number": "616-516-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVIVO",
        "first_name": "HOLLY",
        "credential": "LMSW-C, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-29",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6851114547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.