Individual provider Active NPI

Christine Marie Holston, LMSW

  • Clinical Social Worker
  • Ypsilanti, MI
National Provider Identifier
1073780979
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801089334 Issued in MI
Practice address
555 Towner St
Ypsilanti, MI 48198-5752
Phone
(734) 544-6820
NPI assigned
May 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801089334 MI
Clinical Social Worker 1041C0700X 6801089334 MI Primary

Addresses

Primary practice location

555 Towner St
Ypsilanti, MI 48198-5752

Mailing address

555 Towner Street
Ypsilanti, MI 48197-0915
Phone (734) 544-6820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801089334MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1210464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1073780979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 TOWNER STREET",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481970915",
            "telephone_number": "734-544-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 TOWNER ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985752",
            "telephone_number": "734-544-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLSTON",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-11",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801089334",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801089334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.