Individual provider Active NPI

Averie Noel Holder, LCSW

  • Clinical Social Worker
  • Lubbock, TX
National Provider Identifier
1801673140
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104381 Issued in TX
Practice address
7412 31St St
Lubbock, TX 79407-1022
Phone
(432) 528-6580
NPI assigned
Sep 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 104381 TX Primary

Addresses

Primary practice location

7412 31St St
Lubbock, TX 79407-1022

Mailing address

7412 31St St
Lubbock, TX 79407-1022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240508004118 TX Practitioner - Clinical Social Worker 7416398482 Practice locations: Lubbock, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5717 66TH St
Suite 120
Lubbock, TX 79424-1214
Phone (806) 799-3011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104381TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1801673140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7412 31ST ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794071022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7412 31ST ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794071022",
            "telephone_number": "432-528-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "AVERIE",
        "middle_name": "NOEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "104381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.