Shatanna Holley, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4454G Issued in AL

Practice address

2100 Southbridge Pkwy Ste 650
Birmingham, AL 35209-1317

Phone

(205) 206-6977

Fax

(205) 533-9265

NPI assigned

Jan 19, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1710692199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SOUTHBRIDGE PKWY STE 650",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352091317",
            "telephone_number": "205-206-6977",
            "fax_number": "205-533-9265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SOUTHBRIDGE PKWY STE 650",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352091317",
            "telephone_number": "205-206-6977",
            "fax_number": "205-533-9265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "SHATANNA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "13460",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4454G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "brokentoart.org",
            "affiliation": "Y",
            "affiliationName": "Broken To Art Counseling LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2100 Southbridge Pkwy Ste 650",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352091317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Marie Holland, MD
• Wesley Holland
• Whitney Holland
• Rahab Caroline Holley, RBT
• Robert L Holley, MD
• Shelby Taylor Holley, PHARM.D.
• Timothy Demetrius Holley, O.T.R./L
• Jeffrey Douglas Hollifield, R.PH.
• Katherine Holliman, ALC, NCC
• Abigail Hollingsworth

• Clinical Social Worker in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.