Active NPI
Elizabeth Grace Holloway
- Mental Health Counselor
- Concord, NC
National Provider Identifier
1356196380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 280 Executive Park Dr Ste 100
Concord, NC 28025-1838 - Phone
- (704) 237-4240
- NPI assigned
- Apr 22, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
280 Executive Park Dr Ste 100
Concord, NC 28025-1838
Mailing address
7937 Latchington CT
Charlotte, NC 28227-3191
Phone (336) 831-4362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2129 E 7TH St
Charlotte, NC 28204-3337
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanctuary Counseling Group | Mental Health | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Health Counselor
- Charlotte, NC
- NPI 1386785251
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713744000000",
"number": "1356196380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7937 LATCHINGTON CT",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282273191",
"telephone_number": "336-831-4362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 EXECUTIVE PARK DR STE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251838",
"telephone_number": "704-237-4240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLOWAY",
"first_name": "ELIZABETH",
"middle_name": "GRACE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-22",
"last_updated": "2024-04-22",
"certification_date": "2024-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.