Individual provider Active NPI

Peggy Sue Holifield, LCSW

  • Clinical Social Worker
  • Batesville, AR
National Provider Identifier
1073809976
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2949-B Issued in AR
Practice address
400 Harrison St RM 101
Batesville, AR 72501-6906
Phone
(870) 834-3900
Fax
(870) 627-5760
NPI assigned
Jun 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2949-B AR Primary
Social Worker 104100000X 2949-B AR

Addresses

Primary practice location

400 Harrison St RM 101
Batesville, AR 72501-6906

Mailing address

PO Box 2344
Batesville, AR 72503-2344
Phone (870) 847-0379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2949-BARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Victory Counseling LLC CurrentSince Mar 17, 2024 Accepting new patients

Locations

400 Harrison St
Rm 101
Batesville, AR 72501
Phone (870) 291-3707

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1073809976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2344",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725032344",
            "telephone_number": "870-847-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HARRISON ST RM 101",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725016906",
            "telephone_number": "870-834-3900",
            "fax_number": "870-627-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLIFIELD",
        "first_name": "PEGGY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2949-B",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "2949-B",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.