Active NPI
Holly Reilly, TLMFT
- Marriage & Family Therapist
- Ottumwa, IA
National Provider Identifier
1376902346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 079803
- Practice address
- 105 S Vine St
Ottumwa, IA 52501-3164 - Phone
- (641) 683-5993
- Fax
- (641) 684-4826
- NPI assigned
- Feb 18, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 079803 | IA | Primary |
Addresses
Primary practice location
105 S Vine St
Ottumwa, IA 52501-3164
Mailing address
PO Box 416
Perry, IA 50220-0416
Phone (515) 465-5739
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 079803 | IA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-Iowa Family Therapy Clinic, Inc. | 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 and National Provider Directory roles.
-
- Mental Health Counselor
- Perry, IA
- NPI 1003999624
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455840000000",
"number": "1376902346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 416",
"city": "PERRY",
"state": "IA",
"postal_code": "502200416",
"telephone_number": "515-465-5739",
"fax_number": "515-465-5744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 S VINE ST",
"city": "OTTUMWA",
"state": "IA",
"postal_code": "525013164",
"telephone_number": "641-683-5993",
"fax_number": "641-684-4826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REILLY",
"first_name": "HOLLY",
"credential": "TLMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-18",
"last_updated": "2016-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IA",
"license": "079803",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ottumwa, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.