Active NPI
Cynthia D Holcomb, LSCSW
- Clinical Social Worker
- Derby, KS
National Provider Identifier
1700104635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 5238
- Practice address
- 411 N Osage Rd
Derby, KS 67037-2084 - Phone
- (316) 788-1907
- NPI assigned
- May 17, 2010
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 4695 | KS | |
| Clinical Social Worker | 1041C0700X | 5238 | KS | Primary |
Addresses
Primary practice location
411 N Osage Rd
Derby, KS 67037-2084
Mailing address
411 N Osage Rd
Derby, KS 67037-2084
Phone (316) 788-1907
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4695 | KS | MD | Social Worker |
| 5238 | KS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696377600000",
"number": "1700104635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 N OSAGE RD",
"city": "DERBY",
"state": "KS",
"postal_code": "670372084",
"telephone_number": "316-788-1907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 N OSAGE RD",
"city": "DERBY",
"state": "KS",
"postal_code": "670372084",
"telephone_number": "316-788-1907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLCOMB",
"first_name": "CYNTHIA",
"middle_name": "D",
"credential": "LSCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-17",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KS",
"license": "4695",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "5238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Derby, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.