Individual provider Active NPI

Holly Heather Austinson, CADTP, REGISTERED

  • Addiction (Substance Use Disorder) Counselor
  • Lucerne, CA
National Provider Identifier
1740743293
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
8678-CADTP Issued in CA
Practice address
6302 Thirteenth Avenue
Lucerne, CA 95458
Phone
(707) 274-9101
Fax
(707) 274-9192
NPI assigned
Apr 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 8678-CADTP CA Primary

Addresses

Primary practice location

6302 Thirteenth Avenue
Lucerne, CA 95458

Mailing address

PO Box 1024
Lucerne, CA 95458-1024
Phone (707) 274-9101

Other practice location 1

7000B S Center Dr
Clearlake, CA 95422-8131
Phone (707) 994-7090

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
8678-CADTPCAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1740743293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1024",
            "city": "LUCERNE",
            "state": "CA",
            "postal_code": "954581024",
            "telephone_number": "707-274-9101",
            "fax_number": "707-274-9192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6302 THIRTEENTH AVENUE",
            "city": "LUCERNE",
            "state": "CA",
            "postal_code": "95458",
            "telephone_number": "707-274-9101",
            "fax_number": "707-274-9192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7000B S Center Dr",
            "address_purpose": "LOCATION",
            "city": "Clearlake",
            "state": "CA",
            "postal_code": "954228131",
            "country_code": "US",
            "telephone_number": "707-994-7090",
            "fax_number": "707-994-7164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUSTINSON",
        "first_name": "HOLLY",
        "middle_name": "HEATHER",
        "credential": "CADTP, REGISTERED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "8678-CADTP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lucerne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.