Individual provider Active NPI

Holly R McCloud, LMFT

  • Mental Health Counselor
  • Roanoke, VA
National Provider Identifier
1770966111
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3618 Brambleton Ave Ste D
Roanoke, VA 24018-3659
Phone
(540) 206-8265
Fax
(540) 266-1735
NPI assigned
Jul 2, 2015
Last updated
Mar 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Professional Counselor 101YP2500X

Addresses

Primary practice location

3618 Brambleton Ave Ste D
Roanoke, VA 24018-3659

Mailing address

3618 Brambleton Ave Ste D
Roanoke, VA 24018-3659
Phone (540) 206-8265

Other names 1

  • Holly R Conner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20241023003448 VA Practitioner - Marriage and Family Therapist 6608220413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3618 Brambleton Ave
Suite C
Roanoke, VA 24018-3659
Phone (540) 206-8265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Healing Inc. CurrentSince Oct 10, 2024 Accepting new patients
Star City Therapy Services CurrentSince Jun 24, 2023 Accepting new patients

Locations

3618 Brambleton Ave
Ste C
Roanoke, VA 24018
Phone (540) 206-8265

3618 Brambleton Ave
Ste D
Roanoke, VA 24018
Phone (540) 206-8265

4220 Cypress Park Dr
Ste B
Roanoke, VA 24018
Phone (540) 772-1872

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1770966111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3618 BRAMBLETON AVE STE D",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183659",
            "telephone_number": "540-206-8265",
            "fax_number": "540-266-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3618 BRAMBLETON AVE STE D",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183659",
            "telephone_number": "540-206-8265",
            "fax_number": "540-266-1735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLOUD",
        "first_name": "HOLLY",
        "middle_name": "R",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "CONNER",
            "middle_name": "R",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.