Individual provider Active NPI

Kelly Diane Darby Holder, PH.D.

  • Clinical Psychologist
  • Grand Rapids, MI
National Provider Identifier
1477565612
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301019678 Issued in MI
Practice address
250 Cherry St SE
Grand Rapids, MI 49503-4608
Phone
(616) 685-5600
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS016389 PA
Clinical Psychologist 103TC0700X 6301019678 MI Primary
Psychologist 103T00000X 2973 TN

Addresses

Primary practice location

250 Cherry St SE
Grand Rapids, MI 49503-4608

Mailing address

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502

Other practice location 1

500 University Dr
Hershey, PA 17033-2360
Phone (717) 531-8515

Other names 1

  • Dr. Kelly Diane Darby-Holder Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20251017000298 MI Practitioner - Clinical Psychologist 6305030438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Loma Linda University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

250 Cherry St SE
Grand Rapids, MI 49503-4608
Phone (616) 685-5600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS016389PAMDPsychologist
2973TNMDPsychologist
6301019678MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Sep 15, 2025 Accepting new patients
Metropolitan Hospital CurrentSince Oct 1, 2025 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Sep 15, 2025 Accepting new patients
Evelyn M Frye Clinical Associates, PC Psychologist PastSince Aug 30, 2009 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

250 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 685-5600

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1477565612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CHERRY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034608",
            "telephone_number": "616-685-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-8515",
            "fax_number": "717-531-6491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "KELLY",
        "middle_name": "DIANE DARBY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS016389",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301019678",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "2973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "DARBY-HOLDER",
            "middle_name": "DIANE",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.