Individual provider Active NPI

Holly St. Cyr, LMHC, LCMHC, ATR

  • Mental Health Counselor
  • Andover, MA
National Provider Identifier
1225693906
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMHC13207 Issued in MA
Practice address
40 Shattuck Rd Ste 250
Andover, MA 01810-2492
Phone
(978) 254-4116
NPI assigned
May 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCMHC4821 NH
Mental Health Counselor 101YM0800X LMHC13207 MA Primary

Addresses

Primary practice location

40 Shattuck Rd Ste 250
Andover, MA 01810-2492

Mailing address

40 Shattuck Rd Ste 250
Andover, MA 01810-2492
Phone (978) 254-4116

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251219001253 MA Practitioner - Mental Health Counselor 6507351251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

40 Shattuck Rd
Suite 250
Andover, MA 01810-2492
Phone (978) 222-3121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMHC13207MAMDMental Health Counselor
LCMHC4821NHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Oct 12, 2025 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Oct 12, 2025 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. Past Accepting new patients

Locations

40 Shattuck Rd
Ste 250
Andover, MA 01810
Phone (603) 505-6847

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1225693906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 SHATTUCK RD STE 250",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018102492",
            "telephone_number": "978-254-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SHATTUCK RD STE 250",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018102492",
            "telephone_number": "978-254-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. CYR",
        "first_name": "HOLLY",
        "credential": "LMHC, LCMHC, ATR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "LCMHC4821",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LMHC13207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

Verify at the official NPI Registry.