NPIMap

Organization Active NPI

Holly Maddy, LLC

  • Clinical Social Worker
  • Crestview Hills, KY
National Provider Identifier
1154586394
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
HOLLY MADDY, LLC
Practice address
328 Thomas More Pkwy
Unit 102
Crestview Hills, KY 41017-3488
Phone
(859) 431-6333
NPI assigned
Jul 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Authorized official

Name
Holly Ann Maddy, LCSWNPI 1912078650
Title
Owner
Phone
(859) 431-6333

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

328 Thomas More Pkwy
Unit 102
Crestview Hills, KY 41017-3488

Mailing address

328 Thomas More Pkwy
Unit 102
Crestview Hills, KY 41017-3488
Phone (859) 431-6333

Other identifiers 2

IdentifierTypeStateIssuer
82001017MedicaidKY
7100924470MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081201000452 KY Part B Supplier - Clinic/Group Practice 2365503968 Receives reassigned benefits from 3 practitioners
Practice locations: Crestview Hills, KY

National Provider Directory

National Provider Directory

Locations

2734 Chancellor Dr
Ste 203
Crestview Hills, KY 41017
Phone (859) 431-6333

328 Thomas More Pkwy
Ste 102
Crestview Hills, KY 41017
Phone (859) 431-6333

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699574400000",
    "number": "1154586394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 THOMAS MORE PKWY",
            "address_2": "UNIT 102",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173488",
            "telephone_number": "859-431-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 THOMAS MORE PKWY",
            "address_2": "UNIT 102",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173488",
            "telephone_number": "859-431-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY MADDY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-28",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A",
        "authorized_official_last_name": "MADDY",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-431-6333",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82001017",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100924470",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.