Individual provider Active NPI

Maria T. Holm, LCSW, MSW, ASW

  • Clinical Social Worker
  • Upland, CA
National Provider Identifier
1265863666
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW74491 Issued in CA
Practice address
1260 E Arrow Hwy BLDG E
Upland, CA 91786-4984
Phone
(760) 499-3855
Fax
(760) 499-3870
NPI assigned
Dec 10, 2013
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 60143 CA
Clinical Social Worker 1041C0700X LCSW74491 CA Primary

Addresses

Primary practice location

1260 E Arrow Hwy BLDG E
Upland, CA 91786-4984

Mailing address

1653 Triangle Dr
Ridgecrest, CA 93555-2614
Phone (760) 499-3617

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mariaholm@rrh.medalliesdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170317001940 CA Practitioner - Clinical Social Worker 2961787700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

751 S Richmond Rd
Suite D
Ridgecrest, CA 93555-8217
Phone (760) 618-2477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW74491CAMDClinical Social Worker
60143CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgecrest Regional Hospital Current Accepting new patients
Maria Holm Licensed Clinical Social Worker Inc Clinical CurrentSince Mar 2, 2022 Accepting new patients

Locations

1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616

1111 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-4571

1111 N China Lake Blvd
#190
Ridgecrest, CA 93555
Phone (760) 499-3855

751 S Richmond Rd
Ste D
Ridgecrest, CA 93555
Phone (760) 618-2477

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1265863666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 TRIANGLE DR",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935552614",
            "telephone_number": "760-499-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 E ARROW HWY BLDG E",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864984",
            "telephone_number": "760-499-3855",
            "fax_number": "760-499-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLM",
        "first_name": "MARIA",
        "middle_name": "T.",
        "name_prefix": "Ms.",
        "credential": "LCSW, MSW,  ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-10",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "60143",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW74491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mariaholm@rrh.medalliesdirect.net",
            "affiliation": "N",
            "endpointDescription": "RRH Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1111 N China Lake Blvd Ste 190",
            "city": "Ridgecrest",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935553131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.