Individual provider Active NPI

Devon Chere Holloway, LPC

  • Professional Counselor
  • Boise, ID
National Provider Identifier
1093483372
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8314 Issued in ID
Practice address
8601 W Emerald St Ste 130
Boise, ID 83704-8209
Phone
(208) 600-2184
NPI assigned
Sep 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8314 ID Primary

Addresses

Primary practice location

8601 W Emerald St Ste 130
Boise, ID 83704-8209

Mailing address

16 Tamarack TRL
Boise, ID 83716-3184
Phone (208) 880-2965

Other names 1

  • Devon Chere Bailey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20260511001635 ID Practitioner - Mental Health Counselor 6406324201 Practice locations: Caldwell, ID

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2055 N Cougar Way
Meridian, ID 83646-3799

717 S Kimball Ave
Suite 200
Caldwell, ID 83605-4187
Phone (208) 600-2184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8314IDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Holloway Counseling LLC Current 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": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1093483372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 TAMARACK TRL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837163184",
            "telephone_number": "208-880-2965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 W EMERALD ST STE 130",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048209",
            "telephone_number": "208-600-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "DEVON",
        "middle_name": "CHERE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "8314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEVON",
            "last_name": "BAILEY",
            "middle_name": "CHERE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.