Active NPI
Holly Kelly Ambrose, LCSW
- Clinical Social Worker
- Port Saint Lucie, FL
National Provider Identifier
1437783222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149008654
- Practice address
- 11 Brisa LN
Port Saint Lucie, FL 34952-7920 - Phone
- (331) 210-4513
- NPI assigned
- Mar 2, 2020
- 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 | 149008654 | IL | Primary |
Addresses
Primary practice location
11 Brisa LN
Port Saint Lucie, FL 34952-7920
Mailing address
11 Brisa LN
Port Saint Lucie, FL 34952-7920
Phone (630) 945-0376
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149008654 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shine Medical Providers PC | Past | Accepting new patients | |
| Uplift Behavioral Health PC | Clinical | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Psychiatry Physician
- Philadelphia, PA
- NPI 1538894050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771372800000",
"number": "1437783222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 BRISA LN",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349527920",
"telephone_number": "630-945-0376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 BRISA LN",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349527920",
"telephone_number": "331-210-4513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMBROSE",
"first_name": "HOLLY",
"middle_name": "KELLY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-02",
"last_updated": "2026-02-18",
"certification_date": "2026-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149008654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.