Individual provider Active NPI

Corey A Hollowell, LCSW

  • Clinical Social Worker
  • Loveland, CO
National Provider Identifier
1083090757
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09925529 Issued in CO
Practice address
201 E 4TH St
Loveland, CO 80537-5601
Phone
(970) 919-0669
NPI assigned
Aug 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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 CSW.09925529 CO Primary
Clinical Social Worker 1041C0700X LC16871 ME

Addresses

Primary practice location

201 E 4TH St
Loveland, CO 80537-5601

Mailing address

201 E 4TH St # 68
Loveland, CO 80537-5601
Phone (970) 919-0669

Other practice location 1

928 12th St
Greeley, CO 80631
Phone (970) 919-0669

Other practice location 2

1190 Lisbon St
Lewiston, ME 04240
Phone (207) 232-7702

Other practice location 3

1190 Lisbon St
Lewiston, ME 04240
Phone (207) 232-7702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20190911003803 CO Practitioner - Clinical Social Worker 7517296809 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC16871MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pursuing Authenticity, PLLC Clinical PastSince Sep 23, 2024 Accepting new patients

Organizations & group practices 2

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": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1083090757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 4TH ST # 68",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805375601",
            "telephone_number": "970-919-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 4TH ST",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805375601",
            "telephone_number": "970-919-0669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "928 12th St",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "80631",
            "country_code": "US",
            "telephone_number": "970-919-0669",
            "fax_number": "970-300-3127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1190 Lisbon St",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ME",
            "postal_code": "04240",
            "country_code": "US",
            "telephone_number": "207-232-7702",
            "fax_number": "207-241-0629",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1190 Lisbon St",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ME",
            "postal_code": "04240",
            "country_code": "US",
            "telephone_number": "207-232-7702",
            "fax_number": "207-241-0629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLOWELL",
        "first_name": "COREY",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-05",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09925529",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC16871",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.