Individual provider Active NPI

Ruth Ann Holland

  • Mental Health Counselor
  • Douglas, WY
National Provider Identifier
1356777528
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1920 Issued in NE
Practice address
1144 Brownfield Rd
Douglas, WY 82633-9104
Phone
(402) 749-0646
Fax
(855) 551-4086
NPI assigned
Sep 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1920 NE Primary

Addresses

Primary practice location

1144 Brownfield Rd
Douglas, WY 82633-9104

Mailing address

1144 Brownfield Rd
Douglas, WY 82633-9104
Phone (402) 749-0646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20250127000208 WY Practitioner - Mental Health Counselor 6406385145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1144 Brownfield Rd
Douglas, WY 82633-9104
Phone (402) 749-0646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1920NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Counseling LLC Mental Health CurrentSince Dec 18, 2024 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.

NPI Registry JSON

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1356777528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 BROWNFIELD RD",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826339104",
            "telephone_number": "402-749-0646",
            "fax_number": "855-551-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 BROWNFIELD RD",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826339104",
            "telephone_number": "402-749-0646",
            "fax_number": "855-551-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "RUTH",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, WY

Sources for this page

Verify at the official NPI Registry.