Active NPI
Stanley Holder
- Addiction (Substance Use Disorder) Counselor
- Winston Salem, NC
National Provider Identifier
1518328160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 22516
- Practice address
- 665 W 4TH St
Winston Salem, NC 27101-2701 - Phone
- (336) 725-8389
- NPI assigned
- Mar 10, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 22516 | NC | Primary |
Addresses
Primary practice location
665 W 4TH St
Winston Salem, NC 27101-2701
Mailing address
665 W 4TH St
Winston Salem, NC 27101-2701
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 |
|---|---|---|---|
| 22516 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513209600000",
"number": "1518328160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "665 W 4TH ST",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271012701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "665 W 4TH ST",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271012701",
"telephone_number": "336-725-8389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLDER",
"first_name": "STANLEY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-10",
"last_updated": "2017-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "22516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.