Individual provider Active NPI

Andrea Rae Holbrook, C.T.R.S.

  • Social Worker
  • Sandusky, MI
National Provider Identifier
1275778672
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
227 E Sanilac Rd
Sandusky, MI 48471-1160
Phone
(810) 648-0330
NPI assigned
Dec 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary
Recreation Therapist 225800000X 53063 MI

Addresses

Primary practice location

227 E Sanilac Rd
Sandusky, MI 48471-1160

Mailing address

227 E Sanilac Rd
Sandusky, MI 48471-1160
Phone (810) 648-0330

Other identifiers 2

IdentifierTypeStateIssuer
1275778672MedicaidMI
1275778672OtherMIOTHER COMMERCIAL INSURANCES

Other names 1

  • Andrea Rae Monroe Former name

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

State licenses

LicenseStateTypeSpecialty
53063MIMDRecreation Therapist

NPI Registry JSON

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

{
    "created_epoch": "1229212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1275778672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 E SANILAC RD",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711160",
            "telephone_number": "810-648-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 E SANILAC RD",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711160",
            "telephone_number": "810-648-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "ANDREA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "C.T.R.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-14",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "MI",
            "license": "53063",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275778672",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER COMMERCIAL INSURANCES",
            "identifier": "1275778672",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "MONROE",
            "middle_name": "RAE",
            "credential": "C.T.R.S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sandusky, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.