Porter Holiday, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-10047 Issued in NM

Practice address

10633 McMichael LN SW
Albuquerque, NM 87121

Phone

(505) 710-5877

NPI assigned

Jul 29, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Elevation Counseling, LLC

  • Psychiatric/Mental Health Registered Nurse
  • Albuquerque, NM
  • NPI 1831514520

  Clinical

  NPD (past)

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1568628667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10633 MCMICHAEL LN SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871213689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10633 MCMICHAEL LN SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87121",
            "telephone_number": "505-710-5877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6612 Gulton Ct NE Ste A",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871094407",
            "country_code": "US",
            "telephone_number": "505-888-1686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLIDAY",
        "first_name": "PORTER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-29",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "M-08603",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-10047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73558524",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Holguin
• Peter Holguin, MD
• Saul I Holguin, DO
• Kalina Holian, MT
• Brittany Holiday
• Ryan Holiday, OD
• Holistic Midwifery
• Holistic Pelvic Health
• Jeri Hollan
• Wendy Coleen Holland Hammer, CHW

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.