Provider Demographics
NPI:1851670582
Name:HOLCOMB, JOBY FRANK (LMHC, CADC)
Entity Type:Individual
Prefix:
First Name:JOBY
Middle Name:FRANK
Last Name:HOLCOMB
Suffix:
Gender:M
Credentials:LMHC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 42ND ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-2701
Mailing Address - Country:US
Mailing Address - Phone:515-255-8399
Mailing Address - Fax:515-255-8405
Practice Address - Street 1:600 42ND ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-2701
Practice Address - Country:US
Practice Address - Phone:515-255-8399
Practice Address - Fax:515-255-8405
Is Sole Proprietor?:No
Enumeration Date:2011-08-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA08065101YA0400X
IA001298101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0469676Medicaid