Active NPI
Paula Vanessa Holloway, MED LMFT
- Marriage & Family Therapist
- Johnson City, TN
National Provider Identifier
1508960204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMT238
- Practice address
- 109 West Watauga Avenue
Johnson City, TN 37604 - Phone
- (423) 232-2700
- NPI assigned
- Sep 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMT238 | TN | Primary |
Addresses
Primary practice location
109 West Watauga Avenue
Johnson City, TN 37604
Mailing address
PO Box 9054
Gray, TN 37615-9054
Phone (423) 467-3600
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3085403 | Other | MAGELLAN SUMMIT | |
| 3085403 | Other | MAGELLAN NAVIGATOR | |
| 3085403 | Other | MAGELLAN PINNACLE | |
| 334969 | Other | VALUE OPTIONS GROUP | |
| 62058260566 | Other | UBH JOHN DEERE |
Other names 1
- Paula Vanessa Gothard
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)
- Enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMT238 | TN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508960204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9054",
"city": "GRAY",
"state": "TN",
"postal_code": "376159054",
"telephone_number": "423-467-3600",
"fax_number": "423-467-3696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 WEST WATAUGA AVENUE",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "37604",
"telephone_number": "423-232-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLOWAY",
"first_name": "PAULA",
"middle_name": "VANESSA",
"name_prefix": "Mrs.",
"credential": "MED LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TN",
"license": "LMT238",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN SUMMIT",
"identifier": "3085403",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN NAVIGATOR",
"identifier": "3085403",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN PINNACLE",
"identifier": "3085403",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS GROUP",
"identifier": "334969",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH JOHN DEERE",
"identifier": "62058260566",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PAULA",
"last_name": "GOTHARD",
"middle_name": "VANESSA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.