Individual provider Active NPI

Alyssa Holly, LCSW

  • Counselor
  • Missoula, MT
National Provider Identifier
1649108994
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
BBH-LCSW-LIC-88643 Issued in MT
Practice address
738 Kensington Ave
Missoula, MT 59801-5720
Phone
(406) 868-7025
NPI assigned
May 8, 2026
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X BBH-LCSW-LIC-88643 MT Primary
Clinical Social Worker 1041C0700X BBH-LCSW-LIC-88643 MT

Addresses

Primary practice location

738 Kensington Ave
Missoula, MT 59801-5720

Mailing address

860 Dakota Ave
Missoula, MT 59802-9666
Phone (406) 868-7025

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BBH-LCSW-LIC-88643MTMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lupine Valley Counseling LLC Counselor Current Accepting new patients

Locations

738 Kensington Ave
Missoula, MT 59801
Phone (406) 540-6580

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": "1778198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1649108994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 DAKOTA AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598029666",
            "telephone_number": "406-868-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 KENSINGTON AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598015720",
            "telephone_number": "406-868-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLY",
        "first_name": "ALYSSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-08",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MT",
            "license": "BBH-LCSW-LIC-88643",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-88643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.