Individual provider Active NPI

Emily Hollidge, MSW LICSW

  • Social Worker
  • Eagan, MN
National Provider Identifier
1356329296
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
13536 Issued in MN
Practice address
2130 Cliff Rd
Ste 210a
Eagan, MN 55122-2487
Phone
(651) 686-8818
NPI assigned
Dec 31, 2005
Last updated
Sep 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 13536 MN Primary

Addresses

Primary practice location

2130 Cliff Rd
Ste 210a
Eagan, MN 55122-2487

Mailing address

4555 Erin Dr
Suite 260
Eagan, MN 55122-3398
Phone (651) 686-8818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20060807000167 MN Practitioner - Clinical Social Worker 2860495199 Practice locations: Eagan, MN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2130 Cliff Rd
210A
Eagan, MN 55122-2487
Phone (651) 452-2266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13536MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aslan Institute Past Accepting new patients

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": "1135987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1356329296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 ERIN DR",
            "address_2": "SUITE 260",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223398",
            "telephone_number": "651-686-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 CLIFF RD",
            "address_2": "STE 210A",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222487",
            "telephone_number": "651-686-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIDGE",
        "first_name": "EMILY",
        "name_prefix": "Ms.",
        "credential": "MSW LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-31",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "13536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.