Organization Active NPI

Holloway Therapy Group, Licensed Clinical Social Worker, Professional Corporation

  • Mental Health Counselor
  • La Canada Flintridge, CA
National Provider Identifier
1073410809
Registry record updated Oct 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
HOLLOWAY THERAPY GROUP, LICENSED CLINICAL SOCIAL WORKER, PROFESSIONAL CORPORATION
Practice address
4362 Hayman Ave
La Canada Flintridge, CA 91011-3226
Phone
(323) 854-7539
NPI assigned
Oct 23, 2026
Last updated
Oct 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2026

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

Authorized official

Name
Ian Walter Holloway, LCSW, PHDNPI 1063711521
Title
President
Phone
(323) 854-7539

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
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

4362 Hayman Ave
La Canada Flintridge, CA 91011-3226

Mailing address

4362 Hayman Ave
La Canada Flintridge, CA 91011-3226
Phone (323) 854-7539

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1792713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792713600000",
    "number": "1073410809",
    "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": {
        "organization_name": "HOLLOWAY THERAPY GROUP, LICENSED CLINICAL SOCIAL WORKER, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-23",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-23",
        "status": "A",
        "authorized_official_last_name": "HOLLOWAY",
        "authorized_official_first_name": "IAN",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-854-7539",
        "authorized_official_credential": "LCSW, PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Canada Flintridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.