Holly Ann Roberts, CAPSW CSAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

132205 Issued in WI

Practice address

221 Ferry St
Eau Claire, WI 54703-5944

Phone

(920) 655-4190

NPI assigned

Oct 21, 2021

Last updated

Oct 31, 2021By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635638400000",
    "number": "1598428914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 FERRY ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547035944",
            "telephone_number": "920-655-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 FERRY ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547035944",
            "telephone_number": "920-655-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "credential": "CAPSW CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-31",
        "certification_date": "2021-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16347",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "132205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverside Counseling Clinic, LLC
• Paul Nelson Roadt, LCSW, CSAC
• Robert L Hume DPM
• Christopher Thomas Roberts, MD
• Hailey Marn Roberts, MD
• James Roberts, MD
• Jeaneen Ann Roberts, LMT
• Patrick Roberts, DPM
• Anna Robertson
• Christian Miles Robertson

• Clinical Social Worker in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2021; 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.