Individual provider Active NPI

Lisa Creech Holt

  • Occupational Therapy Assistant
  • Grandville, MI
National Provider Identifier
1821951765
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5202007718 Issued in MI
Practice address
3400 Wilson Ave SW
Grandville, MI 49418-1854
Phone
(616) 534-5487
NPI assigned
Dec 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5202007718 MI Primary
Occupational Therapy Assistant 224Z00000X 311880

Addresses

Primary practice location

3400 Wilson Ave SW
Grandville, MI 49418-1854

Mailing address

200 Glenhaven Ave NW
Grand Rapids, MI 49504-4932
Phone (616) 301-4426

Other practice location 1

400 Jeffrey St
Cedar Springs, MI 49319-9572
Phone (616) 696-0170

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
5202007718MIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1821951765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GLENHAVEN AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044932",
            "telephone_number": "616-301-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 WILSON AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181854",
            "telephone_number": "616-534-5487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Jeffrey St",
            "address_purpose": "LOCATION",
            "city": "Cedar Springs",
            "state": "MI",
            "postal_code": "493199572",
            "country_code": "US",
            "telephone_number": "616-696-0170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLT",
        "first_name": "LISA",
        "middle_name": "CREECH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-08",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MI",
            "license": "5202007718",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": "311880",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.