Misti Marie Holbrook, LPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

115956 Issued in KY

Practice address

321 E Main St
Morehead, KY 40351-1671

Phone

(606) 784-4161

Fax

(606) 783-9952

NPI assigned

Aug 12, 2006

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 identifiers 4

Other names 1

• Misti Pence-Justice Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

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.

• Pathways Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ashland, KY
  • NPI 1982615043
  Medicare reassignment NPD
• Pathways, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ashland, KY
  • NPI 1609260199
  NPD

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1154333938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411050790",
            "telephone_number": "606-329-8588",
            "fax_number": "606-329-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E MAIN ST",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511671",
            "telephone_number": "606-784-4161",
            "fax_number": "606-783-9952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "MISTI",
        "middle_name": "MARIE",
        "credential": "LPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "115956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11717037",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000226450 NONPAR",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100283710",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9488279",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISTI",
            "last_name": "PENCE-JUSTICE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hillside Dental Dre PLLC
• Terry L Hines, M.ED., MSW, LCSW
• Cheyenne Autumn Hissong
• Danielle M Hobson, BS
• Jessica Hofherr, DPT
• Colby J Holmes, DPM
• Devin Holtzclaw
• Dalton House, MD
• Adam Lee Howard, D.O.
• Kimberly Jo Howard

• Clinical Psychologist in Morehead, KY
• Providers in Morehead, KY by specialty
• Clinical Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.