Organization Active NPI

Holm Psychological Services LLC

  • Clinical Psychologist
  • Eagan, MN
National Provider Identifier
1184330623
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
HOLM PSYCHOLOGICAL SERVICES LLC
Practice address
1585 Thomas Center Dr Ste 106
Eagan, MN 55122-3007
Phone
(612) 405-8409
NPI assigned
Jan 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Authorized official

Name
Dr. Lindsey Ann Holm, PSYD, LPNPI 1922552249
Title
Owner/ Licensed Psychologist
Phone
(612) 405-8409

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

1585 Thomas Center Dr Ste 106
Eagan, MN 55122-3007

Mailing address

1585 Thomas Center Dr Ste 106
Eagan, MN 55122-3007
Phone (612) 405-8409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230504002364 MN Part B Supplier - Clinic/Group Practice 9335504851 Receives reassigned benefits from 1 practitioner
Practice locations: Eagan, MN

National Provider Directory

National Provider Directory

Locations

1585 Thomas Center Dr
Ste 106
Saint Paul, MN 55122
Phone (612) 405-8409

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1184330623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 THOMAS CENTER DR STE 106",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223007",
            "telephone_number": "612-405-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 THOMAS CENTER DR STE 106",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223007",
            "telephone_number": "612-405-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLM PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A",
        "authorized_official_last_name": "HOLM",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/ LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "612-405-8409",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.