Kelley Ann Holloway, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20005 Issued in MD

Practice address

10344 Old Ocean City Blvd Ste 2
Berlin, MD 21811-1162

Phone

(410) 641-3340

Fax

(410) 641-3341

NPI assigned

Aug 21, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Kelley Holloway Wootten Former name

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Three Lower Counties Community Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Princess Anne, MD
  • NPI 1154354744
  Medicare reassignment NPD
• Three Lower Counties Community Services Inc

  • Community/Retail Pharmacy
  • Salisbury, MD
  • NPI 1194768473
  NPD
• Three Lower Counties Community Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Salisbury, MD
  • NPI 1275405714
  NPD

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1396144713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10344 OLD OCEAN CITY BLVD STE 2",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111162",
            "telephone_number": "410-641-3340",
            "fax_number": "410-641-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "KELLEY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "20005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "WOOTTEN",
            "middle_name": "HOLLOWAY",
            "prefix": "MS.",
            "credential": "LCSW-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chelsea Elizabeth Hobson, LCSW-C
• Chequila Vitasha Hoffler
• Jennifer Michelle Hoffman, M.S. CCC-SLP
• Lauren Holfeld, RD, LD
• Erin Elizabeth Hollenbach, CRNP
• Karen J Holmes, COTA/L
• Home Delivery Diabetic Supply
• Hooker Medical LLC
• Hope4Recovery Incorporated
• Amanda Bernice Hopkins, LGSW

• Clinical Social Worker in Berlin, MD
• Providers in Berlin, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.

Verify at the official NPI Registry.