Active NPI
Rochelle James Holtzman, PH.D.
- Clinical Psychologist
- Fort Stewart, GA
National Provider Identifier
1801088729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY003767
- Practice address
- 1061 Harmon Ave Ste 1D03
Fort Stewart, GA 31314-5674 - Phone
- (912) 435-6965
- NPI assigned
- Aug 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2011028427 | MO | |
| Clinical Psychologist | 103TC0700X | PSY003767 | GA | Primary |
Addresses
Primary practice location
1061 Harmon Ave Ste 1D03
Fort Stewart, GA 31314-5674
Mailing address
1061 Harmon Ave Ste 1D03
Fort Stewart, GA 31314-5674
Phone (912) 435-6965
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841281805 | Medicaid | KS |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY003767 | GA | MD | Clinical Psychologist |
| 2011028427 | MO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453766400000",
"number": "1801088729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 HARMON AVE STE 1D03",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145674",
"telephone_number": "912-435-6965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1061 HARMON AVE STE 1D03",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145674",
"telephone_number": "912-435-6965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLTZMAN",
"first_name": "ROCHELLE",
"middle_name": "JAMES",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-14",
"last_updated": "2016-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2011028427",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY003767",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1841281805",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Stewart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.