Holly Jean Wallraff, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

56842 Issued in TX

Practice address

1612 Williams Dr
Georgetown, TX 78628-3660

Phone

(309) 574-0014

NPI assigned

Jul 31, 2012

Last updated

Jul 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, IL2 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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blue Moon Senior Counseling of Illinois LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1841562931
  Medicare reassignment NPD
• Sailor Health Medical PA

  • Psychologist
  • Coral Gables, FL
  • NPI 1841012960

  Clinical, IL, TX

  Medicare reassignment NPD
• Bluebonnet Trails Community MHMR Center

  dba Bluebonnet Trails Community Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Round Rock, TX
  • NPI 1730135864

  Clinical

  NPD (past)
• Trauma and the Art of Healing PLLC

  • Marriage & Family Therapist
  • Georgetown, TX
  • NPI 1811636962
  NPD (past)

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1245586999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4903 HEATHER LN APT A",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494878",
            "telephone_number": "309-574-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283660",
            "telephone_number": "309-574-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLRAFF",
        "first_name": "HOLLY",
        "middle_name": "JEAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-31",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "56842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Walker
• Lisa Wallace, LCSW, LCDC
• Wallflower Therapy, LLC
• Victoria Diane Wallin
• Dharshini Wallooppillai, M.D.
• Leah Walter, LPC
• Matthew Thomas Walters, D.C.
• Kristin Hughes Walton, LCDC
• Tammy Lynne Wanamaker, M.A.
• Michelle M Wang, D.M.D.

• Clinical Social Worker in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.