Individual provider Active NPI

Hollister Wooten Trott, PH.D.

  • Clinical Psychologist
  • Raleigh, NC
National Provider Identifier
1447500087
Registry record updated Jul 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4564 Issued in NC
Practice address
1405 Hillsborough St Ste 205
Raleigh, NC 27605-1828
Phone
(919) 438-0060
NPI assigned
Sep 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NOT ISSUED YET NC
Clinical Psychologist 103TC0700X 4564 NC Primary

Addresses

Primary practice location

1405 Hillsborough St Ste 205
Raleigh, NC 27605-1828

Mailing address

515 Barksdale Dr
Raleigh, NC 27604-2203
Phone (919) 794-1157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20150327002378 NC Practitioner - Clinical Psychologist 6103043039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1405 Hillsborough St
Suite 205
Raleigh, NC 27605-1828
Phone (919) 438-0060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4564NCMDProfessional Counselor
NOT ISSUED YETNCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
White Oak Psychological Services, Inc Clinical CurrentSince Nov 20, 2016 Accepting new patients

Locations

1405 Hillsborough St
Ste 205
Raleigh, NC 27605
Phone (919) 438-0060

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658534400000",
    "number": "1447500087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BARKSDALE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276042203",
            "telephone_number": "919-794-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 HILLSBOROUGH ST STE 205",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051828",
            "telephone_number": "919-438-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROTT",
        "first_name": "HOLLISTER",
        "middle_name": "WOOTEN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2022-07-23",
        "certification_date": "2022-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "NOT ISSUED YET",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.