Individual provider Active NPI

Holly Stuckey, LCSW

  • Clinical Social Worker
  • Norcross, GA
National Provider Identifier
1306443304
Registry record updated Oct 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW007267 Issued in GA
Practice address
5748 Pine Oak Dr
Norcross, GA 30092-3508
Phone
(404) 680-6880
NPI assigned
Oct 4, 2020
Last updated
Oct 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2020

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 CSW007267 GA Primary

Addresses

Primary practice location

5748 Pine Oak Dr
Norcross, GA 30092-3508

Mailing address

5748 Pine Oak Dr
Norcross, GA 30092-3508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 28, 2026 through Jan 28, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CSW007267GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hollystuckey@tdh.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1601769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601769600000",
    "number": "1306443304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5748 PINE OAK DR",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300923508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5748 PINE OAK DR",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300923508",
            "telephone_number": "404-680-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "HOLLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-04",
        "last_updated": "2020-10-04",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

Verify at the official NPI Registry.