Christelle Carol Holder

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11468-123 Issued in WI

Practice address

2108 63Rd St
Kenosha, WI 53143-4454

Phone

(414) 475-2788

NPI assigned

Jul 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Service Associates, SCGroup PAC ID 8426948746, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Service Associates, SC

  dba Pauquette Center for Psychological Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portage, WI
  • NPI 1780610923
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1821777616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6233 39TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427015",
            "telephone_number": "262-654-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 63RD ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531434454",
            "telephone_number": "414-475-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "CHRISTELLE",
        "middle_name": "CAROL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "131793",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11468-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Hill, PT, DPT
• Dale Hilson
• Tanya M. Hoar, NP
• David Hoffman, DPT
• David A Hofmeister, DDS
• Ronald R Holder, PSY.D., LPC-S
• Jessica L Holland, CRNA
• Stephanie Lynn Holland, COTA
• Gladys Emmanuelle Hollant, M.D.
• Nicholas Joseph Hollendonner, DC

• Clinical Social Worker in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.