Individual provider Active NPI

Cassandra Ann Holt Kimbell

  • Mental Health Counselor
  • Dallas, TX
National Provider Identifier
1104425628
Registry record updated Apr 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11336 Issued in CA
Practice address
4849 Greenville Ave Ste 100
Dallas, TX 75206-4187
Phone
(972) 885-0106
Fax
(213) 583-2144
NPI assigned
Oct 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2026

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 11336 CA Primary

Addresses

Primary practice location

4849 Greenville Ave Ste 100
Dallas, TX 75206-4187

Mailing address

4849 Greenville Ave Ste 100
Dallas, TX 75206-4187
Phone (972) 885-0106

Other names 1

  • Cassandra Holt Former name

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

LicenseStateTypeSpecialty
11336CAMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Freestyle Supervision and Emdr Group LLC CurrentSince Apr 9, 2024 Accepting new patients
Freestyle Therapy LLC Mental Health Past Accepting new patients

Locations

4849 Greenville Ave
Ste 100
Dallas, TX 75206
Phone (972) 885-0106

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": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777075200000",
    "number": "1104425628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 GREENVILLE AVE STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752064187",
            "telephone_number": "972-885-0106",
            "fax_number": "213-583-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 GREENVILLE AVE STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752064187",
            "telephone_number": "972-885-0106",
            "fax_number": "213-583-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT KIMBELL",
        "first_name": "CASSANDRA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2026-04-25",
        "certification_date": "2026-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "11336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "HOLT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2026; 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.