Individual provider Active NPI

Dara Holcomb

  • Professional Counselor
  • Southington, CT
National Provider Identifier
1417221003
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
001618 Issued in CT
Practice address
963 Queen St
Suite C
Southington, CT 06489-1282
Phone
(860) 506-5424
NPI assigned
Feb 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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 001618 CT Primary

Addresses

Primary practice location

963 Queen St
Suite C
Southington, CT 06489-1282

Mailing address

963 Queen St
Suite C
Southington, CT 06489-1282

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
001618CTMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1417221003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "963 QUEEN ST",
            "address_2": "SUITE C",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "963 QUEEN ST",
            "address_2": "SUITE C",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891282",
            "telephone_number": "860-506-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLCOMB",
        "first_name": "DARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.