Individual provider Active NPI

Michele Donaldson Holben, LASAC

  • Addiction (Substance Use Disorder) Counselor
  • Phoenix, AZ
National Provider Identifier
1790119063
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LASAC-13027 Issued in AZ
Practice address
3825 N 24TH St
Phoenix, AZ 85016-6512
Phone
(602) 248-8886
NPI assigned
Aug 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LASAC-13027 AZ Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X ICADC 711815 AZ
Addiction (Substance Use Disorder) Counselor 101YA0400X CADAC 2071 AZ

Addresses

Primary practice location

3825 N 24TH St
Phoenix, AZ 85016-6512

Mailing address

3825 N 24TH St
Phoenix, AZ 85016-6512
Phone (602) 248-8886

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
CADAC 2071AZMDAddiction (Substance Use Disorder) Counselor
ICADC 711815AZMDAddiction (Substance Use Disorder) Counselor
LASAC-13027AZMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1790119063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 N 24TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166512",
            "telephone_number": "602-248-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 N 24TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166512",
            "telephone_number": "602-248-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBEN",
        "first_name": "MICHELE",
        "middle_name": "DONALDSON",
        "name_prefix": "Mrs.",
        "credential": "LASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-22",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LASAC-13027",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "ICADC 711815",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "CADAC 2071",
            "primary": false
        }
    ],
    "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 Aug 22, 2013; 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.