Active NPI
Jessica S Holm, PSY.D.
- Psychologist
- Manassas, VA
National Provider Identifier
1235598186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 0810005389
- Practice address
- 8140 Ashton Ave
Suite 200
Manassas, VA 20109-5698 - Phone
- (713) 252-4647
- NPI assigned
- Feb 21, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0810005389 | VA | Primary |
Addresses
Primary practice location
8140 Ashton Ave
Suite 200
Manassas, VA 20109-5698
Mailing address
15400 Snowhill LN
Centreville, VA 20120-1147
Phone (713) 252-4647
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810005389 | VA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456012800000",
"number": "1235598186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15400 SNOWHILL LN",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "201201147",
"telephone_number": "713-252-4647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8140 ASHTON AVE",
"address_2": "SUITE 200",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201095698",
"telephone_number": "713-252-4647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLM",
"first_name": "JESSICA",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-21",
"last_updated": "2016-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VA",
"license": "0810005389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manassas, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.