Active NPI
Kristin Danielle Hollis, LCSW
- Clinical Social Worker
- Camp Hill, PA
National Provider Identifier
1023522687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW019704
- Practice address
- 207 House Ave Ste 109
Camp Hill, PA 17011-2308 - Phone
- (717) 745-6166
- NPI assigned
- Nov 18, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW019704 | PA | Primary |
Addresses
Primary practice location
207 House Ave Ste 109
Camp Hill, PA 17011-2308
Mailing address
207 House Ave Ste 109
Camp Hill, PA 17011-2308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 30, 2025 through May 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW019704 | PA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespire LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732233600000",
"number": "1023522687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 HOUSE AVE STE 109",
"city": "CAMP HILL",
"state": "PA",
"postal_code": "170112308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 HOUSE AVE STE 109",
"city": "CAMP HILL",
"state": "PA",
"postal_code": "170112308",
"telephone_number": "717-745-6166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLIS",
"first_name": "KRISTIN",
"middle_name": "DANIELLE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-18",
"last_updated": "2024-11-22",
"certification_date": "2024-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW019704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camp Hill, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.