Individual provider Active NPI

Holly McIntyre, LCSW

  • Clinical Social Worker
  • Miramar, FL
National Provider Identifier
1689070922
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12230 Issued in FL
Practice address
3809 SW 165TH Ave
Miramar, FL 33027-4642
Phone
(305) 788-6296
NPI assigned
Nov 14, 2014
Last updated
Jun 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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 SW12230 FL Primary

Addresses

Primary practice location

3809 SW 165TH Ave
Miramar, FL 33027-4642

Mailing address

3809 SW 165TH Ave
Miramar, FL 33027-4642
Phone (305) 788-6296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151208002578 FL Practitioner - Clinical Social Worker 3577864966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3809 SW 165TH Ave
Miramar, FL 33027-4642
Phone (305) 788-6296

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW12230FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Feeling & Healing Therapeutic Solutions LLC Clinical CurrentSince Jun 1, 2018 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": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1689070922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 SW 165TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274642",
            "telephone_number": "305-788-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 SW 165TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274642",
            "telephone_number": "305-788-6296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "HOLLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.