Active NPI
Ebony L Holloway
- Clinical Social Worker
- Philadelphia, PA
National Provider Identifier
1376268086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW021990
- Practice address
- 271 W Tulpehocken St
Philadelphia, PA 19144-3209 - Phone
- (240) 308-1814
- NPI assigned
- Oct 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW021990 | PA | Primary |
Addresses
Primary practice location
271 W Tulpehocken St
Philadelphia, PA 19144-3209
Mailing address
271 W Tulpehocken St
Philadelphia, PA 19144-3209
Phone (240) 308-1814
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW021990 | PA | MD | Clinical Social Worker |
Interoperability endpoints
- ebony.holloway.1@28228.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664928000000",
"number": "1376268086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "271 W TULPEHOCKEN ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191443209",
"telephone_number": "240-308-1814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "271 W TULPEHOCKEN ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191443209",
"telephone_number": "240-308-1814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLOWAY",
"first_name": "EBONY",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-05",
"last_updated": "2022-10-05",
"certification_date": "2022-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW021990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.