Individual provider Active NPI

Holly Carter, LCSW

  • Clinical Social Worker
  • Monroe, LA
National Provider Identifier
1073171963
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14614 Issued in LA
Practice address
1691 Bienville Dr
Monroe, LA 71201-3756
Phone
(318) 998-7881
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 14614 LA Primary

Addresses

Primary practice location

1691 Bienville Dr
Monroe, LA 71201-3756

Mailing address

1691 Bienville Dr
Monroe, LA 71201-3756
Phone (318) 998-7881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200108001389 LA Practitioner - Clinical Social Worker 9638504244 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Psychiatric Outpatient, LLC Clinical CurrentSince Nov 15, 2019 Accepting new patients

Locations

1000 McKeen Pl
Monroe, LA 71201
Phone (318) 361-9555

1312 Harrison Ave
Ste C
McComb, MS 39648
Phone (601) 684-8284

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": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1073171963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 BIENVILLE DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013756",
            "telephone_number": "318-998-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 BIENVILLE DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013756",
            "telephone_number": "318-998-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "HOLLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "14614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.