Active NPI
Gus David Holabeck III, MA
- Pastoral Counselor
- Castle Rock, CO
National Provider Identifier
1215314695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- 112140114
- Practice address
- 333 Perry St Ste 206E
Castle Rock, CO 80104-2434 - Phone
- (719) 428-9283
- NPI assigned
- May 5, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | 112140114 | CO | Primary |
Addresses
Primary practice location
333 Perry St Ste 206E
Castle Rock, CO 80104-2434
Mailing address
6047 Whetstone Dr
Colorado Springs, CO 80923-7549
Phone (719) 428-9283
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112140114 | CO | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430784000000",
"number": "1215314695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6047 WHETSTONE DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809237549",
"telephone_number": "719-428-9283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 PERRY ST STE 206E",
"city": "CASTLE ROCK",
"state": "CO",
"postal_code": "801042434",
"telephone_number": "719-428-9283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLABECK",
"first_name": "GUS",
"middle_name": "DAVID",
"name_suffix": "III",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-05",
"last_updated": "2015-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "CO",
"license": "112140114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Castle Rock, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.