Kelli Nicole Holloway, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8486 Issued in TN

Practice address

4844 Bloomfield Dr
Memphis, TN 38125-3356

Phone

(901) 215-8602

Fax

(877) 353-0135

NPI assigned

Oct 10, 2017

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

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelli.holloway.1@20088.direct.athenahealth.com

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.

• My Legacy Counseling Center, LLC

  • Clinical Social Worker
  • Memphis, TN
  • NPI 1073491221
  Medicare reassignment NPD Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  TN

  Medicare reassignment NPD
• Friends for Life Corporation

  • Infectious Disease Physician
  • Memphis, TN
  • NPI 1285398834
  NPD
• Nashville Cares

  • Community/Retail Pharmacy
  • Memphis, TN
  • NPI 1740831072
  NPD

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1720598295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4844 BLOOMFIELD DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381253356",
            "telephone_number": "901-215-8602",
            "fax_number": "877-353-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4844 BLOOMFIELD DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381253356",
            "telephone_number": "901-215-8602",
            "fax_number": "877-353-0135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8295 Tournament Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381258900",
            "country_code": "US",
            "telephone_number": "901-468-3431",
            "fax_number": "877-353-0135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "KELLI",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "8486",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "8486",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annette Yvonne Hollis
• Brandi Nicole Hollis, DNP NNP-BC
• Fenisha Dawn Hollis, AGACNP
• Wainscott Hollis, DDS
• Autumn Renee Holloman
• Olivia Dulaney Holloway, PA
• Richard Dawson Holloway III, FNP-C
• Lori Hollowell
• Tracey L Hollowell, B.A.
• Brandy Hollums, PHARM.D.

• Clinical Social Worker in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.