Individual provider Active NPI

Laura Masterson Holmes, L.C.S.W.

  • Clinical Social Worker
  • Eureka, CA
National Provider Identifier
1598866196
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS13969 Issued in CA
Practice address
3172 Walford Ave Ste 4
Eureka, CA 95503-4898
Phone
(707) 407-8038
Fax
(707) 476-8554
NPI assigned
Sep 26, 2006
Last updated
Nov 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS13969 CA Primary

Addresses

Primary practice location

3172 Walford Ave Ste 4
Eureka, CA 95503-4898

Mailing address

PO Box 161
Hydesville, CA 95547-0161
Phone (707) 407-8038

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

State licenses

LicenseStateTypeSpecialty
LCS13969CAMDClinical Social Worker
13969CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1598866196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161",
            "city": "HYDESVILLE",
            "state": "CA",
            "postal_code": "955470161",
            "telephone_number": "707-407-8038",
            "fax_number": "707-476-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3172 WALFORD AVE STE 4",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034898",
            "telephone_number": "707-407-8038",
            "fax_number": "707-476-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "LAURA",
        "middle_name": "MASTERSON",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS13969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.