Active NPI
Andrea Dawn Holley, MSW, LCSW
- Mental Health Counselor
- Hugo, OK
National Provider Identifier
1679796189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4060
- Practice address
- 2402 Tanglewood LN
Hugo, OK 74743-8507 - Phone
- (580) 372-0933
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Mental Health Counselor | 101YM0800X | 4060 | OK | Primary |
Addresses
Primary practice location
2402 Tanglewood LN
Hugo, OK 74743-8507
Mailing address
2402 Tanglewood LN
Hugo, OK 74743-8507
Phone (580) 372-0933
Other names 1
- Mr. Andrea Dawn Rolf
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4060 | OK | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Pathways Unlimited Inc | Current | Accepting new patients |
Locations
4045 NW 64th St
Ste 520
Oklahoma City, OK 73116
Phone (405) 685-4791
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 and National Provider Directory roles.
-
- Clinical Psychologist
- Oklahoma City, OK
- NPI 1659328284
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717632000000",
"number": "1679796189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2402 TANGLEWOOD LN",
"city": "HUGO",
"state": "OK",
"postal_code": "747438507",
"telephone_number": "580-372-0933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2402 TANGLEWOOD LN",
"city": "HUGO",
"state": "OK",
"postal_code": "747438507",
"telephone_number": "580-372-0933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLEY",
"first_name": "ANDREA",
"middle_name": "DAWN",
"name_prefix": "Mrs.",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2024-06-06",
"certification_date": "2024-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OK",
"license": "4060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANDREA",
"last_name": "ROLF",
"middle_name": "DAWN",
"prefix": "MR.",
"credential": "BA, BHRS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hugo, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.