Individual provider Active NPI

Mary Ellen Holtzman

  • Counselor
  • East Chatham, NY
National Provider Identifier
1154612752
Registry record updated Apr 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
553 Maple Dr
East Chatham, NY 12060-2513
Phone
(413) 629-1262
Fax
(413) 448-2198
NPI assigned
Apr 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

553 Maple Dr
East Chatham, NY 12060-2513

Mailing address

553 Maple Dr
East Chatham, NY 12060-2513
Phone (413) 629-1262

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

NPI Registry JSON

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304035200000",
    "number": "1154612752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 MAPLE DR",
            "city": "EAST CHATHAM",
            "state": "NY",
            "postal_code": "120602513",
            "telephone_number": "413-629-1262",
            "fax_number": "413-448-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 MAPLE DR",
            "city": "EAST CHATHAM",
            "state": "NY",
            "postal_code": "120602513",
            "telephone_number": "413-629-1262",
            "fax_number": "413-448-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTZMAN",
        "first_name": "MARY ELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-29",
        "last_updated": "2011-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Chatham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; 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.