Regina Hollibush, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

18910 Issued in MN

Practice address

12099 Lindstrom LN
Lindstrom, MN 55045-9543

Phone

(651) 257-8896

NPI assigned

Apr 23, 2008

Last updated

Jan 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bamboo Counseling Services PLLC

  • Community/Behavioral Health Agency
  • Lindstrom, MN
  • NPI 1437691128
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1396910022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12099 LINDSTROM LN",
            "city": "LINDSTROM",
            "state": "MN",
            "postal_code": "550459543",
            "telephone_number": "651-243-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12099 LINDSTROM LN",
            "city": "LINDSTROM",
            "state": "MN",
            "postal_code": "550459543",
            "telephone_number": "651-257-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIBUSH",
        "first_name": "REGINA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-23",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18910",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6925-123",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43588300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lukas Gillett, DDS
• Sean Patrick Goolsby, DDS
• Eric Jon Gormanson, D.C.
• Shawna Jo Griffin, FNP
• Kelly Marie Helland, LICSW
• Michael A Hursh, DDS
• Virginia Johnson, RPT
• Kimberley M Johnson DC
• Varghese Daniel Kottarathil
• Lake and Leaf Chiropractic PLLC

• Clinical Social Worker in Lindstrom, MN
• Providers in Lindstrom, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.