Individual provider Active NPI

Joshua C. Holmes

  • Clinical Social Worker
  • Layton, UT
National Provider Identifier
1275966384
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6531111-3501 Issued in UT
Practice address
880 Heritage Park Blvd Ste 230
Layton, UT 84041-5675
Phone
(801) 784-0264
Fax
(801) 682-8008
NPI assigned
Aug 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6531111-3502 UT
Clinical Social Worker 1041C0700X 6531111-3501 UT Primary

Addresses

Primary practice location

880 Heritage Park Blvd Ste 230
Layton, UT 84041-5675

Mailing address

880 Heritage Park Blvd Ste 230
Layton, UT 84041-5675
Phone (801) 784-0264

Other identifiers 1

IdentifierTypeStateIssuer
1275966384MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2026 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6531111-3502UTMDProfessional Counselor
6531111-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Connections Counseling, LLC Clinical CurrentSince Feb 1, 2021 Accepting new patients
Neurorev PLLC PastSince Feb 1, 2019 Accepting new patients

Locations

880 Heritage Park Blvd
Ste 230
Layton, UT 84041
Phone (385) 393-4057

1513 N Hill Field Rd
Ste 1001
Layton, UT 84041

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1275966384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 HERITAGE PARK BLVD STE 230",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415675",
            "telephone_number": "801-784-0264",
            "fax_number": "801-682-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 HERITAGE PARK BLVD STE 230",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415675",
            "telephone_number": "801-784-0264",
            "fax_number": "801-682-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "JOSHUA",
        "middle_name": "C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-12",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "UT",
            "license": "6531111-3502",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6531111-3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275966384",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.