Individual provider Active NPI

Jessica Kaye Holland, MSW, LGSW

  • Clinical Social Worker
  • Mankato, MN
National Provider Identifier
1316715964
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
31511 Issued in MN
Practice address
1400 Madison Ave Ste 610
Mankato, MN 56001-5488
Phone
(507) 387-3777
NPI assigned
Dec 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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 31511 MN Primary

Addresses

Primary practice location

1400 Madison Ave Ste 610
Mankato, MN 56001-5488

Mailing address

1400 Madison Ave Ste 610
Mankato, MN 56001-5488
Phone (507) 387-3777

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adult, Child & Family Services, LLC CurrentSince Dec 17, 2023 Accepting new patients

Locations

1400 Madison Ave
Ste 610
Mankato, MN 56001
Phone (507) 387-3777

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1316715964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MADISON AVE STE 610",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015488",
            "telephone_number": "507-387-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MADISON AVE STE 610",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015488",
            "telephone_number": "507-387-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "JESSICA",
        "middle_name": "KAYE",
        "credential": "MSW, LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "31511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.