Individual provider Active NPI

Kasey S Holyfield

  • Mental Health Counselor
  • Valdosta, GA
National Provider Identifier
1093074205
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1801 Canterbury Dr Ste C
Valdosta, GA 31602-0503
Phone
(229) 244-2030
NPI assigned
May 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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 Primary

Addresses

Primary practice location

1801 Canterbury Dr Ste C
Valdosta, GA 31602-0503

Mailing address

1801 Canterbury Dr Ste C
Valdosta, GA 31602-0503
Phone (229) 427-0057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240716000391 GA Practitioner - Mental Health Counselor 8628513587 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Therapy Center, LLC Mental Health CurrentSince Feb 24, 2026 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince May 31, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

1801 Canterbury Dr
Ste C
Valdosta, GA 31602
Phone (229) 244-2030

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.

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1093074205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 CANTERBURY DR STE C",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316020503",
            "telephone_number": "229-427-0057",
            "fax_number": "215-258-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 CANTERBURY DR STE C",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316020503",
            "telephone_number": "229-244-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLYFIELD",
        "first_name": "KASEY",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-08",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.