Holly Wigmore LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

HOLLY WIGMORE LLC

Doing business as

Holly Wigmore

Practice address

5901 S Macadam Ave Ste 100
Portland, OR 97239-3620

Phone

(503) 843-8862

NPI assigned

Jan 10, 2025

Last updated

Jan 10, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

HOLLY WIGMORE LLCAs reported in NPPES

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

Authorized official

Name

Ms. Holly Wigmore, LPCNPI 1093440539

Title

Practice Owner

Phone

(503) 843-8862

Specialties & licenses 2

Addresses

Other names 1

• Holly Wigmore Doing business as

Part of

Holly Wigmore LLC

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Holly Wigmore, LPC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1093440539
  NPD Authorized official

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

{
    "created_epoch": "1736467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1841000957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SE ALDER ST STE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142400",
            "telephone_number": "503-843-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 S MACADAM AVE STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393620",
            "telephone_number": "503-843-8862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "634 Glenwood Rd Apt 11",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912021549",
            "country_code": "US",
            "telephone_number": "971-227-5345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOLLY WIGMORE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOLLY WIGMORE LLC",
        "enumeration_date": "2025-01-10",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-05",
        "status": "A",
        "authorized_official_last_name": "WIGMORE",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "503-843-8862",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holly Wigmore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelli Lea Holloway, M.D.
• Kellie Marie Holloway, DPT
• Michael Arthur Holloway
• William Holloway, LCAT, LPC
• Holly Matthews, LCSW
• Nicole Lee Holly, MD
• Jolea Hollyfield, RN
• Hollywood Children's Dentistry
• Hollywood Family Dentistry
• Alaina Holm

• Mental Health Clinic/Center (Including Community Mental Health Center) in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.