Matthew Joseph Holkup, LADC, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

18890 Issued in MN

Practice address

1856 Beam Ave Ste 200
Maplewood, MN 55109-1162

Phone

(651) 661-6550

Fax

(651) 661-6551

NPI assigned

Oct 20, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment Care Compare group NPD
• Family Support Services Inc.

  dba Sagent Behavioral Health

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1417232505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1856 BEAM AVE STE 200",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091162",
            "telephone_number": "651-661-6550",
            "fax_number": "651-661-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1856 BEAM AVE STE 200",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091162",
            "telephone_number": "651-661-6550",
            "fax_number": "651-661-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLKUP",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LADC, LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-20",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303057",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1636",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hmong Minnesota Senior Center
• Theresa M Hoffoss, WHCNP
• Hoglund Wallin Dentistry Partnership
• Kenneth Hoj, MD
• Jason D C Holgers, D.O.
• Janessa Star Hollamon
• Kathleen Holliday-Jech, NP
• Erin Elisabeth Hollom, M.D.
• Brian Robert Holst, PT
• Homebridge Housing LLC

• Clinical Social Worker in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.