Individual provider Active NPI

Tammy L Holman, LCSW

  • Social Worker
  • Augusta, ME
National Provider Identifier
1326589755
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LC17920 Issued in ME
Practice address
1 VA Ctr # 171CG
Augusta, ME 04330-6795
Phone
(207) 623-8411
NPI assigned
Mar 18, 2017
Last updated
Jun 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CAC5644 ME
Social Worker 104100000X LC17920 ME Primary

Addresses

Primary practice location

1 VA Ctr # 171CG
Augusta, ME 04330-6795

Mailing address

8 Orchard LN
Hallowell, ME 04347-1212
Phone (207) 446-2099

Other practice location 1

8 Orchard Ln
Hallowell, ME 04347-1212
Phone (207) 446-2099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240814002903 ME Practitioner - Clinical Social Worker 8729526355 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CAC5644MEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Health Affiliates Maine, LLC CurrentSince Jul 17, 2024 Accepting new patients

Locations

306 Rodman Rd
Auburn, ME 04210
Phone (207) 333-3278

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": "1489795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1326589755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 ORCHARD LN",
            "city": "HALLOWELL",
            "state": "ME",
            "postal_code": "043471212",
            "telephone_number": "207-446-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VA CTR # 171CG",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306795",
            "telephone_number": "207-623-8411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 Orchard Ln",
            "address_purpose": "LOCATION",
            "city": "Hallowell",
            "state": "ME",
            "postal_code": "043471212",
            "country_code": "US",
            "telephone_number": "207-446-2099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "TAMMY",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-18",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "CAC5644",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ME",
            "license": "LC17920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.