ROBERTA L HOLMAN (NPI# 1518020403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518020403 |
| Entity Type | Individual |
| Full Name | ROBERTA L HOLMAN |
| Credential | MS, CADC |
| Practice Address |
409 County Road R Black River Falls WI 54615-5129 |
| Mailing Address |
1707 Main St La Crosse WI 54601-4200 |
| Practice Telephone | 7152849477 |
| Practice Fax Number | 7152845547 |
| Mailing Telephone | 6087850001 |
| Mailing Fax Number | 6087850002 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2011-09-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39728900 | 05 | |
| HEALTHPARTNERS | HP80839 | 01 | |
| SECURITY HEALTH PLAN | 51172 | 01 |
| Street Address |
409 COUNTY ROAD R |
| City | BLACK RIVER FALLS |
| State | WI |
| Zip Code | 54615-5129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982918124 | Lt Resources | Community/Behavioral Health | 409 County Road R, Black River Falls, WI 54615-5129 | 2010-07-29 |
| 1871825315 | Family & Children's Center | Clinic/Center | 409 County Road R, Black River Falls, WI 54615-5129 | 2010-02-09 |
| 1932372612 | Lynn L Hoornstra | Counselor | 409 County Road R, Black River Falls, WI 54615-5129 | 2008-04-02 |
| 1275716391 | Kristin Berg | Registered Nurse | 409 County Road R, Black River Falls, WI 54615-5129 | 2007-12-12 |
| 1750563235 | Allison Christine Else | Case Manager/Care Coordinator | 409 County Road R, Black River Falls, WI 54615-5129 | 2007-11-27 |
| 1285816769 | Carol Ann Jarrett | Case Manager/Care Coordinator | 409 County Road R, Black River Falls, WI 54615-5129 | 2007-11-27 |
| 1558542027 | Cheryl Lynn Hanson-liu | Case Manager/Care Coordinator | 409 County Road R, Black River Falls, WI 54615-5129 | 2007-11-26 |
| 1285767657 | Family & Children's Center, Inc | Clinic/Center | 409 County Road R, Black River Falls, WI 54615-5129 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104339118 | Lori Jean Mohring | Counselor | 420 Wi-54, Black River Falls, WI 54615 | 2017-11-13 |
| 1184095788 | Robert Anthony Zupancich | Pharmacist | 611 Hwy 54 East, Black River Falls, WI 54615 | 2015-10-08 |
| 1932545902 | Hera Jane Lonetree-rindahl | Counselor | W9850 Airport Rd, Black River Falls, WI 54615 | 2013-05-17 |
| 1902141344 | Mary Jane Jones | Pharmacist | 610 West Adams St., Black River Falls, WI 54615 | 2012-12-11 |
| 1285905844 | Vera Ellen Heubel | Registered Nurse | N6520 Lumber Jack Guy Road, Black River Falls, WI 54615 | 2012-01-13 |
| 1295048361 | Megan Ryan | Dentist | N6571 Lumberjack Guy Road, Black River Falls, WI 54615 | 2010-07-19 |
| 1912147828 | Evangeline M Suquet | Counselor | W9850 Airport Road, Black River Falls, WI 54615 | 2009-03-05 |
| 1407091192 | Holly Kay Rodenberg | Registered Nurse | N6520 Lumber Jack Guy Rd, Black River Falls, WI 54615 | 2008-12-09 |
| 1841467636 | Pamela Listle | Speech-Language Pathologist | 711 West Adams St., Black River Falls, WI 54615 | 2008-05-12 |
| 1285778969 | Black River Family Dentistry Ltd | Dentist | N6625 County Hwy A, Black River Falls, WI 54615 | 2007-02-16 |
| Find all providers in zip 54615 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104339118 | Lori Jean Mohring | Counselor | 420 Wi-54, Black River Falls, WI 54615 | 2017-11-13 |
| 1174909378 | Jodie Tirado | Counselor | W9850 Airport Rd., Black River Falls, WI 54615-0918 | 2015-08-11 |
| 1932545902 | Hera Jane Lonetree-rindahl | Counselor | W9850 Airport Rd, Black River Falls, WI 54615 | 2013-05-17 |
| 1912147828 | Evangeline M Suquet | Counselor | W9850 Airport Road, Black River Falls, WI 54615 | 2009-03-05 |
| 1972533958 | Steven J Firkins | Counselor | 703 Rose St, Black River Falls, WI 54615-9201 | 2006-07-04 |
| 1750928347 | Danielle Marie Lacost | Counselor | 206 S Roosevelt Rd Ste 124, Black River Falls, WI 54615-8810 | 2019-12-03 |
| 1710442892 | Valerie Miranda Carrimon | Counselor | N6520 Lumberjack Guy Rd, Black River Falls, WI 54615-5405 | 2019-02-04 |
| 1609383306 | Karla Dunlap | Counselor | 206 S Roosevelt Rd Ste 124, Black River Falls, WI 54615 | 2018-01-03 |
| 1881052694 | Curtis Tindall | Counselor | N6520 Lumberjack Guy Rd, Black River Falls, WI 54615-5405 | 2016-02-08 |
| 1003220450 | Duarte Cespedes Perez | Counselor | W9850 Airport Road, Black River Falls, WI 54615-9998 | 2014-06-13 |
| Find all providers in BLACK RIVER FALLS | ||||
| City | BLACK RIVER FALLS |
| Zip Code | 54615 |
Please comment or provide details below to improve the information on ROBERTA L HOLMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.