Individual provider Active NPI

Holly Nicole Coleman, LCMHCS

  • Professional Counselor
  • Statesville, NC
National Provider Identifier
1093783664
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5037 Issued in NC
Practice address
524 Signal Hill Drive Ext
Statesville, NC 28625-4391
Phone
(704) 871-1045
Fax
(704) 873-6647
NPI assigned
Mar 9, 2006
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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 5037 NC Primary

Addresses

Primary practice location

524 Signal Hill Drive Ext
Statesville, NC 28625-4391

Mailing address

284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone (704) 939-1100

Other practice location 1

284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone (704) 939-1100

Other identifiers 4

IdentifierTypeStateIssuer
1093783664MedicaidNC
183722OtherNCMEDCOST
2182522OtherNCCIGNA BEHAVIORAL HEALTH
6102918MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240312003219 NC Practitioner - Mental Health Counselor 3274979216 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5037NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Daymark Recovery Services, Inc. Professional CurrentSince Jan 15, 2024 Accepting new patients

Locations

132 Poplar Grove Connector
Ste B
Boone, NC 28607
Phone (828) 264-8759

284 Executive Park Dr
Ste 100
Kannapolis, NC 28025
Phone (704) 939-1118

1104A S Main St
Lexington, NC 27292
Phone (336) 252-2450

2129 Statesville Blvd
Salisbury, NC 28147
Phone (704) 633-3616

524 Signal Hill Drive Ext
Statesville, NC 28625
Phone (704) 871-1045

Interoperability endpoints

  • Direct secure messaging: holly.robinson.p1@direct.daymarkrecovery.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1093783664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 SIGNAL HILL DRIVE EXT",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254391",
            "telephone_number": "704-871-1045",
            "fax_number": "704-873-6647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "284 Executive Park Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280251833",
            "country_code": "US",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "HOLLY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "LCMHCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "5037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093783664",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "183722",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2182522",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102918",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.