Individual provider Active NPI

Jennie L. Holmes, LPC

  • Professional Counselor
  • Enterprise, AL
National Provider Identifier
1417188756
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2663 Issued in AL
Practice address
830 N Ouida St
Enterprise, AL 36330-2704
Phone
(334) 475-2422
Fax
(334) 475-2760
NPI assigned
Aug 4, 2009
Last updated
May 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2663 AL Primary

Addresses

Primary practice location

830 N Ouida St
Enterprise, AL 36330-2704

Mailing address

830 N Ouida St
Enterprise, AL 36330-2704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20240313002521 AL Practitioner - Mental Health Counselor 4183060163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

830 N Ouida St
Enterprise, AL 36330-2704
Phone (334) 308-2292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2663ALMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
JLH Counseling, LLC CurrentSince Feb 22, 2024 Accepting new patients

Locations

830 N Ouida St
Enterprise, AL 36330
Phone (334) 475-2422

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1417188756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 N OUIDA ST",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 N OUIDA ST",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302704",
            "telephone_number": "334-475-2422",
            "fax_number": "334-475-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "JENNIE",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-04",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "2663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.