Active NPI
Jan K Hollingsworth, LPCC
- Mental Health Counselor
- Albuquerque, NM
National Provider Identifier
1740297100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0803
- Practice address
- 9631 Morrow Ave NE
Albuquerque, NM 87112-2951 - Phone
- (505) 275-2584
- NPI assigned
- Aug 1, 2006
- Last updated
- Jul 9, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0803 | NM | Primary |
Addresses
Primary practice location
9631 Morrow Ave NE
Albuquerque, NM 87112-2951
Mailing address
9631 Morrow Ave NE
Albuquerque, NM 87112-2951
Phone (505) 275-2584
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 118824 | Other | NM | VALUE OPTIONS COMMERCIAL |
| 2202654 | Other | NM | CIGNA LPCC PROVIDER |
| 100626 | Medicaid | NM | |
| NM LICENSE # 0803 | Other | NM | CLINICAL MH COUNSELOR |
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 |
|---|---|---|---|
| 0803 | NM | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hollingsworth, Inc. | Mental Health | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Albuquerque, NM
- NPI 1427169424
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1740297100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9631 MORROW AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871122951",
"telephone_number": "505-275-2584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9631 MORROW AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871122951",
"telephone_number": "505-275-2584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLINGSWORTH",
"first_name": "JAN",
"middle_name": "K",
"name_prefix": "Mrs.",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "0803",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS COMMERCIAL",
"identifier": "118824",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA LPCC PROVIDER",
"identifier": "2202654",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100626",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLINICAL MH COUNSELOR",
"identifier": "NM LICENSE # 0803",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.