Individual provider Active NPI

Erin Nicole Holby, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Forty Fort, PA
National Provider Identifier
1619620184
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL015727 Issued in PA
Practice address
Wyoming Valley Children's Association
1133 Wyoming Ave
Forty Fort, PA 18704
Phone
(570) 714-1246
NPI assigned
Feb 3, 2022
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL015727 PA Primary

Addresses

Primary practice location

Wyoming Valley Children's Association
1133 Wyoming Ave
Forty Fort, PA 18704

Mailing address

Wyoming Valley Children's Association
1133 Wyoming Ave
Forty Fort, PA 18704
Phone (570) 714-1246

Other names 1

  • Erin Nicole Muldoon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250505003091 PA Practitioner - Qualified Speech Language Pathologist 4587181441 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Wyoming Valley Childrens Association Speech-Language Pathologist CurrentSince Feb 23, 2025 Accepting new patients

Locations

1133 Wyoming Ave
Kingston, PA 18704
Phone (570) 714-1246

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1619620184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WYOMING VALLEY CHILDREN'S ASSOCIATION",
            "address_2": "1133 WYOMING AVE",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "18704",
            "telephone_number": "570-714-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WYOMING VALLEY CHILDREN'S ASSOCIATION",
            "address_2": "1133 WYOMING AVE",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "18704",
            "telephone_number": "570-714-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBY",
        "first_name": "ERIN",
        "middle_name": "NICOLE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-03",
        "last_updated": "2024-12-17",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL015727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "MULDOON",
            "middle_name": "NICOLE",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Forty Fort, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.