Individual provider Active NPI

Kristy Holt

  • Counselor
  • Brookpark, OH
National Provider Identifier
1932731353
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C.2002469 Issued in OH
Practice address
5445 Smith Rd
Brookpark, OH 44142-2026
Phone
(216) 332-9360
NPI assigned
Feb 5, 2020
Last updated
Feb 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C.2002469 OH Primary

Addresses

Primary practice location

5445 Smith Rd
Brookpark, OH 44142-2026

Mailing address

5445 Smith Rd
Brookpark, OH 44142-2026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240604003582 OH Practitioner - Mental Health Counselor 8628510724 Reassigns benefits to 2 organizations

Care Compare profile

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

Practice addresses (Care Compare)

795 Sharon Dr
Suite 206
Westlake, OH 44145-1542
Phone (440) 470-0187

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.2002469OHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peter Arian LLC CurrentSince May 1, 2024 Accepting new patients
Kaitlyn Cassidy LLC CurrentSince May 1, 2024 Accepting new patients
Lakeside Therapy CurrentSince Feb 18, 2025 Accepting new patients

Locations

3500 Lorain Ave
Ste 300
Cleveland, OH 44113
Phone (216) 250-1607

795 Sharon Dr
Ste 206
Westlake, OH 44145
Phone (440) 470-0187

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": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1932731353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 SMITH RD",
            "city": "BROOKPARK",
            "state": "OH",
            "postal_code": "441422026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 SMITH RD",
            "city": "BROOKPARK",
            "state": "OH",
            "postal_code": "441422026",
            "telephone_number": "216-332-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "KRISTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.2002469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookpark, OH

Sources for this page

Verify at the official NPI Registry.