James Kenneth Hollingsworth

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2577 Ravenhill Dr
Fayetteville, NC 28303-5451

Phone

(910) 438-0947

NPI assigned

Jul 13, 2020

Sex

Male

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

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.

Opted out of Medicare

Yes, effective Mar 24, 2025 through Mar 24, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Integrated Behavioral Healthcare Services, PA

  • Psychologist
  • Fayetteville, NC
  • NPI 1689842551

  Professional

  NPD
• KRC Counseling Inc.

  • Clinical Social Worker
  • Wilmington, NC
  • NPI 1023557154
  NPD (past)

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1114545563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 CLARK ST # A",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055341",
            "telephone_number": "910-590-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 RAVENHILL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035451",
            "telephone_number": "910-438-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINGSWORTH",
        "first_name": "JAMES",
        "middle_name": "KENNETH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Holland
• William Christopher Holland, OD
• Bryan Holliday, LCSWA, CSAC
• Emma Alicia Holliday, DO
• Richard Wayne Hollings, PH.D
• Hollis L Jones DDS, PLLC
• Leighanna Holloman
• Samantha Nicole Hollon
• Denise Downing Holmes, M.ED.
• Kathleen Herring Holmes, LMSW

• Professional Counselor in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.