Individual provider Active NPI

Estina M Holder, LPC

  • Professional Counselor
  • Hattiesburg, MS
National Provider Identifier
1396977070
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2889 Issued in MS
Practice address
100 Chickasaw Dr
Hattiesburg, MS 39401-2852
Phone
(601) 705-1901
NPI assigned
Aug 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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 2889 MS
Mental Health Counselor 101YM0800X 0795 MS
Professional Counselor 101YP2500X 2889 MS Primary

Addresses

Primary practice location

100 Chickasaw Dr
Hattiesburg, MS 39401-2852

Mailing address

100 Chickasaw Dr
Hattiesburg, MS 39401-2852
Phone (601) 705-1901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20250821003552 MS Practitioner - Mental Health Counselor 4688174998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Chickasaw Dr
Hattiesburg, MS 39401-2852

803 Sunken Rd
Fredericksburg, VA 22401-5401

PO Box
Atlanta, GA 30374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2889MSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince Aug 8, 2025 Accepting new patients

Locations

232 Market St
Jackson, MS 39232
Phone (588) 498-6767

Organizations & group practices 2

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": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1396977070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CHICKASAW DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394012852",
            "telephone_number": "601-705-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHICKASAW DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394012852",
            "telephone_number": "601-705-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "ESTINA",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-14",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "2889",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "0795",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "2889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.