Provider Type Icon

HOLLY ANDREA SACKETT NPI 1619388360


NPI Information

NPI: 1619388360
Provider Name: HOLLY ANDREA SACKETT
Classification: Counselor - 101Y00000X
Entity Type: Individual
Organization: MARISA BORGERT PSYD LLC

PECOS Registration: Yes

Address:
6550 GARBER RD
DAYTON, OH
ZIP 45415
Phone: (937) 293-8300
Get Directions

Holly Andrea Sackett is a counselor in Dayton, OH with 7 years of experience. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Holly Andrea Sackett NPI is 1619388360. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Graduation Year:2017

The provider's business location address is:

6550 GARBER RD
DAYTON, OH
ZIP 45415-000
Phone: (937) 293-8300

The NPI 1619388360 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 5/15/2014 and was last updated on 5/15/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1101Y00000XMEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.