Active NPI
Sean Holman II
- Clinical Social Worker
- Las Cruces, NM
National Provider Identifier
1346473519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- M06976
- Practice address
- 100 W Griggs Ave
Las Cruces, NM 88001-1234 - Phone
- (575) 647-2869
- Fax
- (575) 647-2898
- NPI assigned
- Sep 3, 2009
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3904 | NM | |
| Clinical Social Worker | 1041C0700X | M06976 | NM | Primary |
Addresses
Primary practice location
100 W Griggs Ave
Las Cruces, NM 88001-1234
Mailing address
100 W Griggs Ave
Las Cruces, NM 88001-1234
Phone (575) 647-2869
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47043 | Medicaid | NM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3904 | NM | MD | Addiction (Substance Use Disorder) Counselor |
| M06976 | NM | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251936000000",
"number": "1346473519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 W GRIGGS AVE",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880011234",
"telephone_number": "575-647-2869",
"fax_number": "575-647-2898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 W GRIGGS AVE",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880011234",
"telephone_number": "575-647-2869",
"fax_number": "575-647-2898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMAN",
"first_name": "SEAN",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-03",
"last_updated": "2009-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NM",
"license": "3904",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "M06976",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47043",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.