Individual provider Active NPI

Caelan Holcombe, MHC-LP

  • Mental Health Counselor
  • Rochester, NY
National Provider Identifier
1396332862
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
013063 Issued in NY
Practice address
300 Hylan Dr Ste 6
Rochester, NY 14623-4216
Phone
(585) 201-8418
Fax
(844) 792-8133
NPI assigned
Dec 30, 2020
Last updated
Mar 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P107024 NY
Mental Health Counselor 101YM0800X 013063 NY Primary

Addresses

Primary practice location

300 Hylan Dr Ste 6
Rochester, NY 14623-4216

Mailing address

38 Jersey St
Rochester, NY 14609-7222
Phone (585) 489-8960

Other identifiers 2

IdentifierTypeStateIssuer
013063OtherNYDIVISION OF PROFESSIONAL LICENSING SERVICES
P107024OtherNYDIVISION OF PROFESSIONAL LICENSING SERVICES

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
P107024NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1396332862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 JERSEY ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146097222",
            "telephone_number": "585-489-8960",
            "fax_number": "844-792-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HYLAN DR STE 6",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146234216",
            "telephone_number": "585-201-8418",
            "fax_number": "844-792-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLCOMBE",
        "first_name": "CAELAN",
        "credential": "MHC-LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P107024",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "013063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIVISION OF PROFESSIONAL LICENSING SERVICES",
            "identifier": "013063",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIVISION OF PROFESSIONAL LICENSING SERVICES",
            "identifier": "P107024",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.