Individual provider Active NPI

Debora R Holt, M.ED

  • Mental Health Counselor
  • Moses Lake, WA
National Provider Identifier
1861533556
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00004897 Issued in WA
Practice address
404 S Division St
Moses Lake, WA 98837-1957
Phone
(509) 764-7474
Fax
(509) 764-7480
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH00004897 WA Primary

Addresses

Primary practice location

404 S Division St
Moses Lake, WA 98837-1957

Mailing address

PO Box 760
Moses Lake, WA 98837-0121
Phone (509) 764-7474

Other identifiers 1

IdentifierTypeStateIssuer
601772853OtherWAUBI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240328002762 WA Practitioner - Mental Health Counselor 0749627529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 Nat Washington Way
Ephrata, WA 98823-1982
Phone (509) 764-7474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
LH00004897WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Basin Counseling, Inc. Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

200 Nat Washington Way
Ephrata, WA 98823
Phone (509) 754-3330

404 S Division St
Moses Lake, WA 98837
Phone (509) 764-7474

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1861533556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 760",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988370121",
            "telephone_number": "509-764-7474",
            "fax_number": "509-764-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 S DIVISION ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371957",
            "telephone_number": "509-764-7474",
            "fax_number": "509-764-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "DEBORA",
        "middle_name": "R",
        "credential": "M.ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00004897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBI",
            "identifier": "601772853",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

Verify at the official NPI Registry.