Individual provider Active NPI

Patricia Holloway, LCSW

  • Clinical Social Worker
  • Hampton, VA
National Provider Identifier
1306908744
Registry record updated Aug 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904005219 Issued in VA
Practice address
600 Medical Dr
Suite a
Hampton, VA 23666-1769
Phone
(757) 788-0600
Fax
(757) 788-0932
NPI assigned
Dec 14, 2006
Last updated
Aug 20, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904005219 VA Primary
Mental Health Counselor 101YM0800X 0904005219 VA
Professional Counselor 101YP2500X 0904005219 VA

Addresses

Primary practice location

600 Medical Dr
Suite a
Hampton, VA 23666-1769

Mailing address

300 Medical Dr
2ND Floor
Hampton, VA 23666-1765
Phone (757) 788-0092

Other identifiers 1

IdentifierTypeStateIssuer
1659424448MedicaidVA

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
0904005219VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Associates of Denbigh, Inc Mental Health PastSince Nov 1, 2014 Accepting new patients
Hampton Newport News Community Services Board PastSince Jan 8, 1996 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, 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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250726400000",
    "number": "1306908744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEDICAL DR",
            "address_2": "2ND FLOOR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661765",
            "telephone_number": "757-788-0092",
            "fax_number": "757-788-0969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MEDICAL DR",
            "address_2": "SUITE A",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661769",
            "telephone_number": "757-788-0600",
            "fax_number": "757-788-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "PATRICIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2009-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005219",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904005219",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0904005219",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659424448",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.