Active NPI
Jennifer L Holt, CDCA
- Addiction (Substance Use Disorder) Counselor
- Chesapeake, OH
National Provider Identifier
1487294658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.173710
- Practice address
- 103 2ND Ave
Chesapeake, OH 45619-1134 - Phone
- (740) 451-7627
- NPI assigned
- Jan 15, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.173710 | OH | Primary |
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
103 2ND Ave
Chesapeake, OH 45619-1134
Mailing address
103 2ND Ave
Chesapeake, OH 45619-1134
Phone (740) 451-7627
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
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.173710 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590710400000",
"number": "1487294658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 2ND AVE",
"city": "CHESAPEAKE",
"state": "OH",
"postal_code": "456191134",
"telephone_number": "740-451-7627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 2ND AVE",
"city": "CHESAPEAKE",
"state": "OH",
"postal_code": "456191134",
"telephone_number": "740-451-7627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLT",
"first_name": "JENNIFER",
"middle_name": "L",
"credential": "CDCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-15",
"last_updated": "2020-05-29",
"certification_date": "2020-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.173710",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.