Active NPI
Evan Jonathan Holcomb, LCSW
- Clinical Social Worker
- Prestonsburg, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 253263
- Practice address
- 104 S Front Ave
Prestonsburg, KY 41653-1614 - Phone
- (606) 886-8572
- Fax
- (606) 886-4433
- NPI assigned
- Aug 9, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 7296 | KY | |
| Clinical Social Worker | 1041C0700X | 253263 | KY | Primary |
Addresses
Primary practice location
104 S Front Ave
Prestonsburg, KY 41653-1614
Mailing address
104 S Front Ave
Prestonsburg, KY 41653-1614
Phone (606) 886-8572
Other practice location 1
1925 Frederica St Ste 200
Owensboro, KY 42301-4818
Phone (270) 926-2484
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
445 N Cross Pointe Blvd
Evansville, IN 47715-4013
Phone (812) 476-7200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7296 | KY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain Comprehensive Care Center, Inc. | Current | Accepting new patients | |
| Deaconess Hospital, Inc | Clinical | Current | Accepting new patients |
| Mountain Comprehensive Care Center, Inc. | Current | Accepting new patients | |
| Deaconess Hospital Inc | Clinical | Current | Accepting new patients |
| Truenorth Treatment Center, LLC | Clinical | Current | Accepting new patients |
Locations
445 N Cross Pointe Blvd
Evansville, IN 47715
Phone (812) 402-2003
7200 E Indiana St
Evansville, IN 47715
Phone (812) 476-7200
121 E 2nd St
Ste 401
Owensboro, KY 42303
Phone (270) 240-1785
1100 Walnut St
Owensboro, KY 42301
Phone (270) 689-6500
838 S Mayo Trl
Paintsville, KY 41240
Phone (606) 788-1345
104 S Front Ave
Prestonsburg, KY 41653
Phone (606) 688-6857
Organizations & group practices 6
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.
-
- Hospitalist Physician
- Evansville, IN
- NPI 1427097443
-
- Mental Health Counselor
- Prestonsburg, KY
- NPI 1760491674
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Owensboro, KY
- NPI 1871067611
Clinical
-
- Federally Qualified Health Center (FQHC)
- Paintsville, KY
- NPI 1699386078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710201600000",
"number": "1265818520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 S FRONT AVE",
"city": "PRESTONSBURG",
"state": "KY",
"postal_code": "416531614",
"telephone_number": "606-886-8572",
"fax_number": "606-886-4433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 S FRONT AVE",
"city": "PRESTONSBURG",
"state": "KY",
"postal_code": "416531614",
"telephone_number": "606-886-8572",
"fax_number": "606-886-4433"
}
],
"practiceLocations": [
{
"address_1": "1925 Frederica St Ste 200",
"address_purpose": "LOCATION",
"city": "Owensboro",
"state": "KY",
"postal_code": "423014818",
"country_code": "US",
"telephone_number": "270-926-2484",
"fax_number": "270-685-6015",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLCOMB",
"first_name": "EVAN",
"middle_name": "JONATHAN",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-09",
"last_updated": "2024-03-12",
"certification_date": "2024-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KY",
"license": "7296",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "253263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Prestonsburg, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.