Individual provider Active NPI

Laura a. Hollister, MDIV, LCPC, NCC

  • Mental Health Counselor
  • Ellicott City, MD
National Provider Identifier
1841821543
Registry record updated Jul 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC12269 Issued in MD
Practice address
3355 St Johns LN
Ellicott City, MD 21042
Phone
(443) 896-3945
Fax
(410) 480-0110
NPI assigned
Jan 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC12269 MD Primary
Pastoral Counselor 101YP1600X

Addresses

Primary practice location

3355 St Johns LN
Ellicott City, MD 21042

Mailing address

3355 St Johns LN
Ellicott City, MD 21042
Phone (443) 896-3945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240109001251 MD Practitioner - Mental Health Counselor 2769831528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3355 Saint Johns LN
Ellicott City, MD 21042-2605
Phone (443) 896-3945

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Words for Life LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

3355 Saint Johns Ln
Ellicott City, MD 21042
Phone (443) 203-8050

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689984000000",
    "number": "1841821543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 ST JOHNS LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21042",
            "telephone_number": "443-896-3945",
            "fax_number": "410-480-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 ST JOHNS LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21042",
            "telephone_number": "443-896-3945",
            "fax_number": "410-480-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLISTER",
        "first_name": "LAURA A.",
        "name_prefix": "Ms.",
        "credential": "MDIV, LCPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2023-07-22",
        "certification_date": "2023-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC12269",
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.