MS. JUDY D HOLT CCDC T, NPI 1164418687 — WATERTOWN (SD)

NPI 1164418687

14+ Years Experience Individual

MS. JUDY D HOLT CCDC T

09/20/2005
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1164418687
NPI NUMBER

About MS. JUDY D HOLT

MS. JUDY D HOLT is a provider established in WATERTOWN, SD. The NPI number of MS. JUDY D HOLT is 1164418687 and was assigned on 09/20/2005. The practitioners primary taxonomy code is: 101YA0400X with license number: 3912 .

Mailing address

  • City: WATERTOWN
  • State: SD
  • Postal code: 572016030
  • Phone: 6058860123
  • Fax: 6058865447
  • Address: PO BOX 1030

Primary Practice Address

  • Region : WATERTOWN, SD
  • NPI : 1164418687
  • Phone : 6058860123
  • Fax : 6058865447
  • Postalcode : 572012823
  • Address : 123 19TH ST NE

Provider taxonomy - Counselor

  • Taxonomy code: 101YA0400X
  • License number: 3912

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • MS. JUDY D HOLT CCDC T
  • Address : 123 19TH ST NE
  • Region : WATERTOWN, SD
  • NPI : 1164418687
  • Phone : 6058860123
  • Fax : 6058865447
  • Postalcode : 572012823

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address123 19TH ST NE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameWATERTOWN
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameSD
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code572012823
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6058860123
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number6058865447
The fax number associated with the location address of the provider being identified.
NPI1164418687
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1101YA0400X
Provider Enumeration Date09/20/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)MS. JUDY D HOLT
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing AddressPO BOX 1030
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameWATERTOWN
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameSD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code572016030
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6058860123
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number6058865447
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1101YA0400X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Counselor
Provider License Number 13912
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorX
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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