Active NPI
Taylor Julian Holder, LCSW
- Clinical Social Worker
- Jacksonville, NC
National Provider Identifier
1205069242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C007437
- Practice address
- 472 Western Blvd
Suite D
Jacksonville, NC 28546-6824 - Phone
- (910) 238-4513
- Fax
- (910) 238-4745
- NPI assigned
- Aug 25, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P005318 | NC | |
| Clinical Social Worker | 1041C0700X | C007437 | NC | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1709 | NC |
Addresses
Primary practice location
472 Western Blvd
Suite D
Jacksonville, NC 28546-6824
Mailing address
472D Western Blvd
Jacksonville, NC 28546-6824
Phone (910) 238-4513
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C007437 | NC | MD | Clinical Social Worker |
| P005318 | NC | MD | Clinical Social Worker |
| 1709 | NC | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palms Wellness Center Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Jacksonville, NC
- NPI 1821326828
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388966400000",
"number": "1205069242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "472D WESTERN BLVD",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285466824",
"telephone_number": "910-238-4513",
"fax_number": "910-238-4745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "472 WESTERN BLVD",
"address_2": "SUITE D",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285466824",
"telephone_number": "910-238-4513",
"fax_number": "910-238-4745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLDER",
"first_name": "TAYLOR",
"middle_name": "JULIAN",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-25",
"last_updated": "2014-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P005318",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C007437",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "1709",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.