Active NPI
Les Jay Holub, RPH
- Counselor
- Fort Mohave, AZ
National Provider Identifier
1780342345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- S012947
- Practice address
- 4823 S Highway 95
Fort Mohave, AZ 86426-8314 - Phone
- (928) 704-4443
- NPI assigned
- Dec 1, 2021
- Last updated
- Dec 1, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | S012947 | AZ | Primary |
Addresses
Primary practice location
4823 S Highway 95
Fort Mohave, AZ 86426-8314
Mailing address
2234 Sunrise TRL
Bullhead City, AZ 86442-4409
Phone (928) 201-5374
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D01684094 | Other | AZ | DRIVERS LICENSE |
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S012947 | AZ | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1780342345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2234 SUNRISE TRL",
"city": "BULLHEAD CITY",
"state": "AZ",
"postal_code": "864424409",
"telephone_number": "928-201-5374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4823 S HIGHWAY 95",
"city": "FORT MOHAVE",
"state": "AZ",
"postal_code": "864268314",
"telephone_number": "928-704-4443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLUB",
"first_name": "LES",
"middle_name": "JAY",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-12-01",
"last_updated": "2021-12-01",
"certification_date": "2021-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AZ",
"license": "S012947",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "D01684094",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Mohave, AZ
- Hematology Oncology Associates of North Jersey, LLC (Dr. Mohtaseb Cancer Center and Blood Disorders)
- Richard E Hendrix, MD
- Larry Coomer Hernandez, PTA
- Cara Michelle Hetrick, RN, BSN
- Nathaniel Charles Hollister, MD
- Cari Dawn Horne, CSFA
- HPH Homecare, LLC
- Han-Chin C Huang, FNP
- Deborah Ann Hughson, RNP
- Tyler Lee Hunt, CRNA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.