Holly S Whitaker, MA, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC01515 Issued in MN

Practice address

1360 Energy Park Dr Ste 330
Saint Paul, MN 55108-5298

Phone

(651) 439-2059

Fax

(888) 675-8262

NPI assigned

Feb 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Mental Health Counselor

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Group practices

Rush IncGroup PAC ID 8224131750, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rush Inc

  • Psychologist
  • Stillwater, MN
  • NPI 1801942040
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1205970761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 101ST AVE N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341083201",
            "telephone_number": "651-439-2059",
            "fax_number": "888-675-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 ENERGY PARK DR STE 330",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085298",
            "telephone_number": "651-439-2059",
            "fax_number": "888-675-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "HOLLY",
        "middle_name": "S",
        "credential": "MA,  LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-17",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "OH",
            "license": "E0008095",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0008095",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC01515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Michelle Wheeler, LICSW
• Robert Michael Wheeler, MD
• Robyn Lynn Wheeler, RN
• Alanna Jane Whelan, APRN, CRNA
• Timothy Meyer Whisler
• Cara Brienne White, LICSW
• Cortney D White, M.D.
• G Zachariah White, PSYD
• Helen White, MPS
• James Robert White, M.D.

• Mental Health Counselor in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.