Individual provider Active NPI

Tricia Anthea Holness, LCSW

  • Clinical Social Worker
  • New Windsor, NY
National Provider Identifier
1336483031
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079820-1 Issued in NY
Practice address
301 Balsam Dr
New Windsor, NY 12553-4755
Phone
(845) 476-6613
NPI assigned
Nov 19, 2012
Last updated
Nov 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 079820-1 NY Primary

Addresses

Primary practice location

301 Balsam Dr
New Windsor, NY 12553-4755

Mailing address

301 Balsam Dr
New Windsor, NY 12553-4755
Phone (845) 476-6613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20130325000000 NY Practitioner - Clinical Social Worker 3375788326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5020 Route 9W
Suite 104
Newburgh, NY 12550-7901
Phone (845) 956-0122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
079820-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Counseling and Wellness Inc Clinical CurrentSince Mar 18, 2019 Accepting new patients

Locations

5020 Route 9W
Ste 104
Newburgh, NY 12550
Phone (845) 237-2862

Organizations & group practices 1

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": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1336483031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BALSAM DR",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125534755",
            "telephone_number": "845-476-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 BALSAM DR",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125534755",
            "telephone_number": "845-476-6613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLNESS",
        "first_name": "TRICIA",
        "middle_name": "ANTHEA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079820-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Windsor, NY

Sources for this page

Verify at the official NPI Registry.