Individual provider Active NPI

Andrew Holst, DO, LCSW

  • Psychiatry Physician
  • Newark, NJ
National Provider Identifier
1609114180
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
202504078 Issued in NC
Practice address
183 S Orange Ave
Newark, NJ 07103-2757
Phone
(336) 430-7898
NPI assigned
Jan 17, 2013
Last updated
Jun 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Psychiatry Physician 2084P0800X 202504078 NC Primary

Addresses

Primary practice location

183 S Orange Ave
Newark, NJ 07103-2757

Mailing address

183 S Orange Ave
Newark, NJ 07103-2757

Other practice location 1

962 S Fayetteville St
Asheboro, NC 27203-6410
Phone (336) 430-7898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
202504078NCMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1609114180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 S ORANGE AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 S ORANGE AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757",
            "telephone_number": "336-430-7898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "962 S Fayetteville St",
            "address_purpose": "LOCATION",
            "city": "Asheboro",
            "state": "NC",
            "postal_code": "272036410",
            "country_code": "US",
            "telephone_number": "336-430-7898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLST",
        "first_name": "ANDREW",
        "credential": "DO, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-17",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "202504078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.