Individual provider Active NPI

Jillane E Holland, LISW-S

  • Clinical Social Worker
  • Centerville, OH
National Provider Identifier
1124314745
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1303346-SUPV Issued in OH
Practice address
6601 Centerville Business Pkwy Ste 310
Centerville, OH 45459-2697
Phone
(216) 468-5000
NPI assigned
Jun 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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 I.1303346-SUPV OH Primary

Addresses

Primary practice location

6601 Centerville Business Pkwy Ste 310
Centerville, OH 45459-2697

Mailing address

7465 Elk Creek Rd
Middletown, OH 45042-9266
Phone (216) 926-9638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231213003734 OH Practitioner - Clinical Social Worker 7012366230 Reassigns benefits to 3 organizations
I20260312002218 IN Practitioner - Clinical Social Worker 7012366230 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PA Post Acute Services PCGroup PAC ID 7911374905, 35 clinicians

Practice addresses (Care Compare)

5226 E 82ND St
Indianapolis, IN 46250-1628
Phone (317) 842-6668

5404 Georgetown Rd
Indianapolis, IN 46254-5500
Phone (317) 291-5404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PA Post Acute Services PC CurrentSince Jan 14, 2025 Accepting new patients
Psychological & Behavioral Consultants, LLC Clinical CurrentSince Dec 1, 2023 Accepting new patients
CNP Operating Co LLC CurrentSince Jan 14, 2025 Accepting new patients
Community Mental Health Centers of Warren County, Inc PastSince Mar 1, 2020 Accepting new patients

Locations

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122
Phone (216) 245-4468

6601 Centerville Business Pkwy
Ste 310
Dayton, OH 45459
Phone (937) 637-3765

8055 Addison Rd
Masury, OH 44438
Phone (330) 448-2547

25111 Country Club Blvd
Ste 290
North Olmsted, OH 44070
Phone (440) 614-2520

Organizations & group practices 4

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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1124314745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7465 ELK CREEK RD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450429266",
            "telephone_number": "216-926-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 CENTERVILLE BUSINESS PKWY STE 310",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592697",
            "telephone_number": "216-468-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "JILLANE",
        "middle_name": "E",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1303346-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

Verify at the official NPI Registry.