Individual provider Active NPI

Angela Jo Holbrook, LISW-S, CDCA

  • Social Worker
  • Lancaster, OH
National Provider Identifier
1700397577
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.2103029-SUPV Issued in OH
Practice address
220 E Walnut St
Lancaster, OH 43130-4464
Phone
(740) 277-6043
Fax
(740) 277-7595
NPI assigned
Oct 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I.2103029-SUPV OH Primary
Social Worker 104100000X 1701288 OH

Addresses

Primary practice location

220 E Walnut St
Lancaster, OH 43130-4464

Mailing address

2540 Carroll Eastern Rd
Carroll, OH 43112-9647
Phone (740) 438-7034

Other practice location 1

201 S Columbus St
Lancaster, OH 43130-4315
Phone (740) 687-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251231000796 OH Practitioner - Clinical Social Worker 7517453368 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Services for Behavioral HealthGroup PAC ID 9234372525, 39 clinicians

Practice addresses (Care Compare)

11 Graham Dr
Athens, OH 45701-1430
Phone (740) 594-6807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1701288OHMDSocial Worker
I.2103029-SUPVOHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Services for Behavioral Health CurrentSince Dec 17, 2025 Accepting new patients
The Recovery Center Past Accepting new patients
The Recovery Center Past Accepting new patients
Integrated Services for Behavioral Health PastSince Dec 17, 2025 Accepting new patients

Locations

11 Graham Dr
Athens, OH 45701
Phone (740) 594-6807

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/isaoh/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1700397577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 CARROLL EASTERN RD",
            "city": "CARROLL",
            "state": "OH",
            "postal_code": "431129647",
            "telephone_number": "740-438-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E WALNUT ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431304464",
            "telephone_number": "740-277-6043",
            "fax_number": "740-277-7595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 S Columbus St",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "OH",
            "postal_code": "431304315",
            "country_code": "US",
            "telephone_number": "740-687-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "ANGELA",
        "middle_name": "JO",
        "credential": "LISW-S, CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-19",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.2103029-SUPV",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "1701288",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.