Organization Active NPI

Holly Nabozny Inc

  • Clinical Social Worker
  • Clinton TWP, MI
National Provider Identifier
1023410131
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801090910 Issued in MI
Legal business name
HOLLY NABOZNY INC
Practice address
36389 Harper Ave
Clinton TWP, MI 48035-2958
Phone
(248) 219-8756
NPI assigned
Sep 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Holly NaboznyNPI 1114026051
Title
President
Phone
(248) 219-8756

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801090910 MI Primary

Addresses

Primary practice location

36389 Harper Ave
Clinton TWP, MI 48035-2958

Mailing address

119 Rhode Island Ave
Royal Oak, MI 48067-3730
Phone (248) 219-8756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141031001287 MI Part B Supplier - Clinic/Group Practice 8426279662 Receives reassigned benefits from 1 practitioner
Practice locations: Royal Oak, MI

National Provider Directory

National Provider Directory

Locations

36389 Harper Ave
Clinton Twp, MI 48035
Phone (248) 219-8756

333 W 7th St
Royal Oak, MI 48067
Phone (248) 219-8756

415 S West St
Royal Oak, MI 48067
Phone (248) 219-8756

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1023410131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 RHODE ISLAND AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673730",
            "telephone_number": "248-219-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36389 HARPER AVE",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480352958",
            "telephone_number": "248-219-8756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY NABOZNY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-19",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "NABOZNY",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-219-8756"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801090910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.