Individual provider Active NPI

Wyonne C. Holland

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1245344340
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3540-123 Issued in WI
Practice address
230 W Wells St
Milwaukee, WI 53203-1866
Phone
(414) 324-4999
Fax
(414) 276-6819
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 3540-123 WI Primary

Addresses

Primary practice location

230 W Wells St
Milwaukee, WI 53203-1866

Mailing address

1304A W Ring St
Milwaukee, WI 53206-2860
Phone (414) 324-4999

Other identifiers 1

IdentifierTypeStateIssuer
40993400MedicaidWI

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
3540-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Adult Psychotherapy Clinic, LLC Past Accepting new patients
Wings of Dove Counseling Service LLC Clinical PastSince Aug 13, 2008 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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245344340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304A W RING ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532062860",
            "telephone_number": "414-324-4999",
            "fax_number": "414-324-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W WELLS ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532031866",
            "telephone_number": "414-324-4999",
            "fax_number": "414-276-6819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "WYONNE",
        "middle_name": "C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "3540-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40993400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.