MS. SALLY ANN HOLBROOK (LCPC-S) – Mental Health Counselor, NPI 1679821987
Mental Health Counselor
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
436 MENTAL HEALTH COUNSELOR in ID
Provider Addresses for MS. SALLY ANN HOLBROOK (LCPC-S)
PO BOX 47
TWIN FALLS, ID 83308
Phone: (208) 732-0995
Fax: (208) 732-0993
Type: Mailing
493 EASTLAND DR.
TWIN FALLS, ID 83303
Phone: (208) 732-0995
Fax: (208) 732-0993
Type: Location
148 S COLE RD
BOISE, ID 837090932
Phone: (086) 683-8320
Fax: (208) 969-8380
Type: Mailing
496 SHOUP AVE W STE F
TWIN FALLS, ID 833015043
Phone: (208) 683-8320
Fax: (208) 969-8380
Type: Location
148 S Cole Rd
Boise, ID 837090932
Phone: (086) 683-8320
Fax: (208) 969-8380
Type: Location
213 N Main St Ste 1B
Moscow, ID 838432700
Phone: (208) 683-8320
Fax: (208) 969-8380
Type: Location
411 Main Street Unit G
Kamiah, ID 83536
Phone: (208) 683-8320
Fax: (208) 969-8380
Type: Location
509 S Middleton Rd
Middleton, ID 836446046
Phone: (208) 683-8320
Fax: (208) 969-8380
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-08-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250804000585 | I | Mental Health Counselor | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83308)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | ID | |
| Mental Health Counselor | ID | |
| Clinical Social Worker | ID | |
| Clinical Social Worker | ID | |
| Mental Health Counselor | ID | |
| Mental Health Counselor | ID | |
| Clinical Social Worker | ID | |
| Clinical Social Worker | ID | |
| Clinical Social Worker | ID | |
| Mental Health Counselor | ID |
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