Katie M Holmes, LCSW, PHD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

075114 Issued in NY

Practice address

14 Shore Lane
Bay Shore, NY 11706-8734

Phone

(631) 666-6873

NPI assigned

Jan 25, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538214879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 OCEAN AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068716",
            "telephone_number": "631-463-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 SHORE LANE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068734",
            "telephone_number": "631-666-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "KATIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "LCSW, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hispanic Counseling Center
• Krista Hoefling
• Paprika Rosemary Hofsommer, LMSW
• Angelic Marie Holland, LPN
• Tanya Holland
• Khiana Holmes
• Caroline Grace Holochwost
• Glenn Holt
• Anastasiya Holubyeva, M.D.
• Meaghan Horan, FAMILY NP

• Clinical Social Worker in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Clinical Social Worker in New York

• 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.

Verify at the official NPI Registry.