Holly Smith Rakestraw, LPC, NCC, NCSC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

975 Issued in MS

Practice address

813 Varsity Dr Ste 5
Tupelo, MS 38801-4694

Phone

(662) 840-2005

Fax

(662) 840-2107

NPI assigned

Feb 7, 2019

Last updated

Feb 7, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1093270613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 MEGS LN",
            "city": "SALTILLO",
            "state": "MS",
            "postal_code": "388667940",
            "telephone_number": "662-213-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 VARSITY DR STE 5",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014694",
            "telephone_number": "662-840-2005",
            "fax_number": "662-840-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKESTRAW",
        "first_name": "HOLLY",
        "middle_name": "SMITH",
        "credential": "LPC, NCC, NCSC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-07",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; 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.