Individual provider Active NPI

Erica Holmes

  • Mental Health Counselor
  • Phoenix, AZ
National Provider Identifier
1730893967
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LAC-21656 Issued in AZ
Practice address
3519 E Shea Blvd Ste 119a
Phoenix, AZ 85028-3341
Phone
(602) 448-8007
NPI assigned
Jan 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LAC-21656 AZ Primary

Addresses

Primary practice location

3519 E Shea Blvd Ste 119a
Phoenix, AZ 85028-3341

Mailing address

4949 E Van Buren St Unit 61024
Phoenix, AZ 85026-9801
Phone (602) 448-8007

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

LicenseStateTypeSpecialty
LAC-21656AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Its Bigger Than Me Mental Health CurrentSince May 7, 2024 Accepting new patients
Its Bigger Than Me Ibtm LLC Mental Health CurrentSince Mar 26, 2023 Accepting new patients

Locations

3519 E Shea Blvd
Ste 119A
Phoenix, AZ 85028
Phone (602) 448-8007

Organizations & group practices 2

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": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1730893967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 E VAN BUREN ST UNIT 61024",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850269801",
            "telephone_number": "602-448-8007",
            "fax_number": "855-330-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 E SHEA BLVD STE 119A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283341",
            "telephone_number": "602-448-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "ERICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-21656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.

Verify at the official NPI Registry.