Individual provider Active NPI

Holly M Lynch, SWT

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1497052575
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1450777-SUPV Issued in OH
Practice address
11801 Buckeye Rd
Cleveland, OH 44120-2620
Phone
(216) 831-2255
Fax
(216) 378-3906
NPI assigned
Feb 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S.1000670-TRNE OH
Clinical Social Worker 1041C0700X I.1450777-SUPV OH Primary

Addresses

Primary practice location

11801 Buckeye Rd
Cleveland, OH 44120-2620

Mailing address

3737 Lander Rd
Pepper Pike, OH 44124-5712
Phone (216) 831-2255

Other identifiers 1

IdentifierTypeStateIssuer
0268768MedicaidOH

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1450777-SUPVOHMDClinical Social Worker
S.1000670-TRNEOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindfully, LLC Clinical CurrentSince Feb 19, 2024 Accepting new patients
Ohioguidestone Current Accepting new patients
Ohioguidestone CurrentSince Jan 27, 2023 Accepting new patients
Ohioguidestone CurrentSince Jan 27, 2023 Accepting new patients
Mindfully, LLC CurrentSince Feb 19, 2024 Accepting new patients
Beech Brook Past Accepting new patients

Locations

202 E Bagley Rd
Berea, OH 44017
Phone (440) 260-8327

3500 Carnegie Ave
Cleveland, OH 44115
Phone (440) 260-8327

1251 Nilles Rd
Ste 5
Fairfield, OH 45014
Phone (732) 993-4599

11565 Pearl Rd
Ste 200
Strongsville, OH 44136
Phone (440) 846-0862

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1497052575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 LANDER RD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245712",
            "telephone_number": "216-831-2255",
            "fax_number": "216-378-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 BUCKEYE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202620",
            "telephone_number": "216-831-2255",
            "fax_number": "216-378-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "HOLLY",
        "middle_name": "M",
        "credential": "SWT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-25",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1000670-TRNE",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1450777-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0268768",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.