Active NPI
Lea Ann Holder, LICSW
- Clinical Social Worker
- Vancouver, WA
National Provider Identifier
1942458765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW60710896
- Practice address
- 1701 E Evergreen Blvd
Vancouver, WA 98661-4289 - Phone
- (360) 281-3114
- Fax
- (844) 400-6494
- NPI assigned
- Sep 4, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW60710896 | WA | Primary |
Addresses
Primary practice location
1701 E Evergreen Blvd
Vancouver, WA 98661-4289
Mailing address
8601 NE Sunnyside Dr
Vancouver, WA 98662-2854
Phone (360) 281-3114
Other practice location 1
847 NE 19th Ave
Suite 100
Portland, OR 97232-2684
Phone (503) 552-6203
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543536000000",
"number": "1942458765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8601 NE SUNNYSIDE DR",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986622854",
"telephone_number": "360-281-3114",
"fax_number": "844-400-6494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 E EVERGREEN BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986614289",
"telephone_number": "360-281-3114",
"fax_number": "844-400-6494"
}
],
"practiceLocations": [
{
"address_1": "847 NE 19th Ave",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972322684",
"country_code": "US",
"telephone_number": "503-552-6203",
"fax_number": "503-552-6208",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLDER",
"first_name": "LEA ANN",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-04",
"last_updated": "2018-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW60710896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.