Danielle Charlotte Marie Holmstrom

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5797 Issued in OK

Practice address

14625 NE 23Rd St
Choctaw, OK 73020-8728

Phone

(405) 390-8131

NPI assigned

Jan 9, 2013

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

Other identifiers 1

Other names 1

• Ms. Danielle Charlotte Marie Loftis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tri-City Youth & Family Center, Inc.

  • Community/Behavioral Health Agency
  • Choctaw, OK
  • NPI 1588812895
  NPD (past)
• Tri-City Youth & Family Center, Inc.

  • Mental Health Counselor
  • Choctaw, OK
  • NPI 1881775211
  NPD (past)

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1114264397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2433 SW 54TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731196019",
            "telephone_number": "405-532-7608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14625 NE 23RD ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730208728",
            "telephone_number": "405-390-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMSTROM",
        "first_name": "DANIELLE",
        "middle_name": "CHARLOTTE MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-09",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "5797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200481330B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "LOFTIS",
            "middle_name": "CHARLOTTE MARIE",
            "prefix": "MS.",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrew E Heuser, PT
• Jennifer Hite, PHARMD
• Jeffrey Michael Hogan, PT, MPT
• Holistic Physical Therapy and Wellness
• Cristina Michelle Holloway, MA, LMFT CANDIDATE
• Home Therapy Services PLLC
• Hometown Primary Care, PLLC
• Ellisa Hudson, APRN
• Ico Primary Care, LLC
• Immediate Care of Oklahoma

• Professional Counselor in Choctaw, OK
• Providers in Choctaw, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.