Individual provider Active NPI

Lynn Brooks Holliman, LSCSW

  • Clinical Social Worker
  • Platte City, MO
National Provider Identifier
1639288418
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2020012657 Issued in MO
Practice address
2900 Williamsburg Ter Apt B302
Platte City, MO 64079-7667
Phone
(816) 859-3211
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2020012657 MO Primary

Addresses

Primary practice location

2900 Williamsburg Ter Apt B302
Platte City, MO 64079-7667

Mailing address

2900 Williamsburg Ter Apt B302
Platte City, MO 64079-7667
Phone (816) 859-3211

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: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1627 Main St
Suite 200
Kansas City, MO 64108-1317

402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2372KSMDPsychologist
2020012657MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pawnee Mental Health Service, Inc. Past Accepting new patients
Emovere Therapy and Intensives, LLC PastSince Sep 10, 2023 Accepting new patients
Fortis, LLC Clinical PastSince Aug 18, 2024 Accepting new patients
Pawnee Mental Health Service, Inc. Past Accepting new patients
Kanza Mental Health and Guidance Center, Inc. Social Worker Past Accepting new patients

Organizations & group practices 5

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1639288418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 WILLIAMSBURG TER APT B302",
            "city": "PLATTE CITY",
            "state": "MO",
            "postal_code": "640797667",
            "telephone_number": "816-859-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 WILLIAMSBURG TER APT B302",
            "city": "PLATTE CITY",
            "state": "MO",
            "postal_code": "640797667",
            "telephone_number": "816-859-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIMAN",
        "first_name": "LYNN",
        "middle_name": "BROOKS",
        "name_prefix": "Ms.",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2020012657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Platte City, MO

Sources for this page

Verify at the official NPI Registry.