NPIMap

Individual provider Active NPI

Cassandra Holliday

  • Addiction (Substance Use Disorder) Counselor
  • Baltimore, MD
National Provider Identifier
1366100653
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
ADT2372 Issued in MD
Practice address
4345 Old Frederick Rd
Baltimore, MD 21229-2838
Phone
(240) 516-8021
NPI assigned
Dec 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ADT2372 MD
Professional Counselor 101YP2500X ADT2372 MD
Addiction (Substance Use Disorder) Counselor 101YA0400X ADT2372 MD Primary

Addresses

Primary practice location

4345 Old Frederick Rd
Baltimore, MD 21229-2838

Mailing address

4345 Old Frederick Rd
Baltimore, MD 21229-2838
Phone (240) 516-8021

Other identifiers 1

IdentifierTypeStateIssuer
4345MedicaidMD

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL sandycaishelly@gmail.com Direct
CONNECT URL sandycaishelly@gmail.com Health Information Exchange (HIE)

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

LicenseStateTypeSpecialty
ADT2372MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
C Holliday Counseling Service LLC Counselor CurrentSince Dec 12, 2021 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": "1638489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1366100653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4345 OLD FREDERICK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212292838",
            "telephone_number": "240-516-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4345 OLD FREDERICK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212292838",
            "telephone_number": "240-516-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIDAY",
        "first_name": "CASSANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-03",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "ADT2372",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "ADT2372",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "ADT2372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4345",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "sandycaishelly@gmail.com",
            "affiliation": "N",
            "endpointDescription": "sandycaishelly@gmail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4345 Old Frederick Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212292838",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "sandycaishelly@gmail.com",
            "affiliation": "N",
            "endpointDescription": "sandycaishelly@gmail.com",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4345 Old Frederick Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212292838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.