Ian Walter Holloway, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

82669 Issued in CA

Practice address

4362 Hayman Ave
La Canada Flintridge, CA 91011-3226

Phone

(323) 854-7539

NPI assigned

Mar 23, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720310400000",
    "number": "1063711521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4362 HAYMAN AVE",
            "city": "LA CANADA FLINTRIDGE",
            "state": "CA",
            "postal_code": "910113226",
            "telephone_number": "323-854-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4362 HAYMAN AVE",
            "city": "LA CANADA FLINTRIDGE",
            "state": "CA",
            "postal_code": "910113226",
            "telephone_number": "323-854-7539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "IAN",
        "middle_name": "WALTER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-23",
        "last_updated": "2024-07-07",
        "certification_date": "2024-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "82669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hastings Wound Solutions
• Hello Speech Therapy Center
• Kendall Leigh Henry, PA
• Hillside Physical Therapy, Inc.
• Holloway Therapy Group, LLC
• Joel a Badeaux, MD, a Professional Corp
• Garen Karaguezian, PHARM.D.
• Debbie K Kawamura, RD
• Ashley Celler Kennedy, MA, LMFT
• Lauren Kim

• Clinical Social Worker in La Canada Flintridge, CA
• Providers in La Canada Flintridge, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.