Individual provider Active NPI

Nicole Anne Holbrook, LMSW

  • Social Worker
  • Lansing, MI
National Provider Identifier
1881102945
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801106651 Issued in MI
Practice address
1717 N High St
Lansing, MI 48906-4529
Phone
(517) 372-4700
Fax
(517) 372-3314
NPI assigned
Jan 11, 2018
Last updated
May 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X MI
Social Worker 104100000X 6801106651 MI Primary

Addresses

Primary practice location

1717 N High St
Lansing, MI 48906-4529

Mailing address

640 3 Mile Rd NW Ste G
Grand Rapids, MI 49544-8209
Phone (517) 234-3826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200904001616 MI Practitioner - Clinical Social Worker 6406273457 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of Ingham, Eaton & Clinton Counties Past Accepting new patients
Cristo Rey Community Center Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1881102945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 3 MILE RD NW STE G",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495448209",
            "telephone_number": "517-234-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 N HIGH ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489064529",
            "telephone_number": "517-372-4700",
            "fax_number": "517-372-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "NICOLE",
        "middle_name": "ANNE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-11",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801106651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.