Active NPI
Jessica Ann Kynion Holland, LPCC-S
- Mental Health Counselor
- Elyria, OH
National Provider Identifier
1073878799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E.1100550-S
- Practice address
- 312 3Rd St
Elyria, OH 44035-5618 - Phone
- (440) 323-5707
- NPI assigned
- Jul 9, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C.1100550-TRNE | OH | |
| Mental Health Counselor | 101YM0800X | E.1100550-S | OH | Primary |
Addresses
Primary practice location
312 3Rd St
Elyria, OH 44035-5618
Mailing address
2248 Garden Dr
Avon, OH 44011-2609
Phone (740) 438-1762
Other practice location 1
624 Market Ave N
Canton, OH 44702-1017
Phone (330) 454-7066
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
| License | State | Type | Specialty |
|---|---|---|---|
| C.1100550-TRNE | OH | MD | Mental Health Counselor |
| E.1100550-S | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathways Counseling and Growth Center | Current | Accepting new patients | |
| Pathways Counseling and Growth Center | Past | Accepting new patients |
Locations
312 3rd St
Elyria, OH 44035
Phone (440) 323-5707
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/pathwayscounselingcenter/r4/
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Elyria, OH
- NPI 1760450837
-
- Community/Behavioral Health Agency
- Grafton, OH
- NPI 1801104799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614816000000",
"number": "1073878799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2248 GARDEN DR",
"city": "AVON",
"state": "OH",
"postal_code": "440112609",
"telephone_number": "740-438-1762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 3RD ST",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440355618",
"telephone_number": "440-323-5707"
}
],
"practiceLocations": [
{
"address_1": "624 Market Ave N",
"address_purpose": "LOCATION",
"city": "Canton",
"state": "OH",
"postal_code": "447021017",
"country_code": "US",
"telephone_number": "330-454-7066",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLLAND",
"first_name": "JESSICA",
"middle_name": "ANN KYNION",
"credential": "LPCC-S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-09",
"last_updated": "2021-03-04",
"certification_date": "2021-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "C.1100550-TRNE",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E.1100550-S",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elyria, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.