Individual provider Active NPI

Kathleen R. Holmes

  • Professional Counselor
  • Newark, OH
National Provider Identifier
1508992876
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0602104 Issued in OH
Practice address
505 Mount Vernon Rd
Suite 300
Newark, OH 43055-4682
Phone
(740) 507-4014
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.0602104 OH Primary

Addresses

Primary practice location

505 Mount Vernon Rd
Suite 300
Newark, OH 43055-4682

Mailing address

505 Mount Vernon Rd
Suite 300
Newark, OH 43055-4682
Phone (740) 507-4014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240106000097 OH Practitioner - Mental Health Counselor 0840204004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ace Psychological Services LLCGroup PAC ID 7810217536, 12 clinicians

Practice addresses (Care Compare)

575 Industrial Pkwy
Heath, OH 43056-1647
Phone (740) 877-3440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
E.0602104OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ace Psychological Services LLC CurrentSince Jan 1, 2024 Accepting new patients
Winds of Change Counseling Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

575 Industrial Pkwy
Heath, OH 43056
Phone (740) 618-8388

Organizations & group practices 2

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1508992876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 MOUNT VERNON RD",
            "address_2": "SUITE 300",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430554682",
            "telephone_number": "740-507-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 MOUNT VERNON RD",
            "address_2": "SUITE 300",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430554682",
            "telephone_number": "740-507-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "KATHLEEN",
        "middle_name": "R.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0602104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.