Katelyn Tamara Holmberg

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1521 S Cushman St
Fairbanks, AK 99701-6203

Phone

(907) 452-8251

Fax

(907) 459-3842

NPI assigned

Oct 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Katelyn Tamara Holmberg Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Tanana Chiefs Conference

  • Community/Behavioral Health Agency
  • Fairbanks, AK
  • NPI 1841835980
  NPD

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1134844541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 S CUSHMAN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997016203",
            "telephone_number": "907-452-8251",
            "fax_number": "907-459-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 S CUSHMAN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997016203",
            "telephone_number": "907-452-8251",
            "fax_number": "907-459-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMBERG",
        "first_name": "KATELYN",
        "middle_name": "TAMARA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Katelyn.Holmberg@tananachiefs.org",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Katelyn.Holmberg@tananachiefs.org",
            "address_1": "1521 S Cushman St",
            "city": "Fairbanks",
            "state": "AK",
            "country_code": "US",
            "postal_code": "997016203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "HOLMBERG",
            "middle_name": "TAMARA",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jaida Nichole Hollenbeck
• Josephine Hollens
• Andrea Louise Hollingsworth
• Larissa Ladonna Hollowell
• Fredrick Holmberg
• Shirley May Holmberg, BA
• Darla K Holmes
• Jennifer A Holt, PA-C
• Mikaila Holt
• Tracie Holt, YOUTH COUNSELORS

• Counselor in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.