CMS-1500 Box 24J / 33a • NPI
1700397577
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
1041C0700X (CMS 80)
Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical
Box 32 Service Location & ZIP+4
220 E WALNUT ST, LANCASTER, OH, 43130-4464
✓ 9-Digit EDI 837 ZIP+4 (43130-4464)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1700397577 (ANGELA JO HOLBROOK, LISW-S, CDCA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1700397577 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | ANGELA JO HOLBROOK, LISW-S, CDCA |
| Plain-English Specialty | Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical NUCC Code: 1041C0700X (Social Worker, Clinical) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 220 E WALNUT ST, LANCASTER, OH, 43130-4464 |
| Practice Telephone / Fax | Tel: (740) 277-6043 | Fax: (740) 277-7595 |
| Administrative Mailing Address | 2540 CARROLL EASTERN RD, CARROLL, OH, 43112-9647 |
| Enumeration & Last Sync | Enumerated: 2017-10-19 | CMS Record Updated: 2026-09-18 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (1041C0700X)
What Does Taxonomy Code 1041C0700X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1041C0700X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ANGELA JO HOLBROOK, LISW-S, CDCA)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
104100000X — Social WorkerPlain English: Licensed & Credentialed Social Worker | State: OH | License: I.2103029-SUPV | Primary: Secondary |
104100000X — Social WorkerPlain English: Licensed & Credentialed Social Worker | State: OH | License: 1701288 | Primary: Secondary |
1041C0700X — Social Worker, ClinicalPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical | State: OH | License: I.2103029-SUPV | Primary: Yes (Primary) |
101YA0400X — Counselor, Addiction (Substance Use Disorder)Plain English: Licensed & Credentialed Counselor, Addiction (Substance Use Disorder) | State: OH | License: LICDC.161915 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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