Individual provider Active NPI

William Grant Holley, LCSW MSW

  • Clinical Social Worker
  • Frankfort, IL
National Provider Identifier
1528288891
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149004943 Issued in IL
Practice address
20635 Abbey Woods CT N Ste 209
Frankfort, IL 60423-3188
Phone
(815) 640-1669
NPI assigned
Apr 27, 2007
Last updated
Feb 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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 149004943 LCSW IL
Clinical Social Worker 1041C0700X 149004943 IL Primary

Addresses

Primary practice location

20635 Abbey Woods CT N Ste 209
Frankfort, IL 60423-3188

Mailing address

20635 Abbey Woods CT N Ste 209
Frankfort, IL 60423-3188
Phone (815) 640-1669

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

LicenseStateTypeSpecialty
149004943ILMDClinical Social Worker
149004943 LCSWILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Olive Branch Counseling Associates, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1528288891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20635 ABBEY WOODS CT N STE 209",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233188",
            "telephone_number": "815-640-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20635 ABBEY WOODS CT N STE 209",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233188",
            "telephone_number": "815-640-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "WILLIAM",
        "middle_name": "GRANT",
        "name_prefix": "Mr.",
        "credential": "LCSW MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-27",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149004943 LCSW",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149004943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.