Active NPI
Thomas Lawrence Hollowaty, M.S.W.
- Clinical Social Worker
- South Lake Tahoe, CA
National Provider Identifier
1740348259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 5732-C
- Practice address
- 1447 Herbert Ave
Suite 204
South Lake Tahoe, CA 96150-8976 - Phone
- (530) 307-8554
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT13320 | CA | |
| Clinical Social Worker | 1041C0700X | 5732-C | NV | Primary |
Addresses
Primary practice location
1447 Herbert Ave
Suite 204
South Lake Tahoe, CA 96150-8976
Mailing address
1447 Herbert Ave
Suite 204
South Lake Tahoe, CA 96150-8976
Phone (530) 307-8554
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EPS015720 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5732-C | NV | MD | Clinical Social Worker |
| MFT13320 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281312000000",
"number": "1740348259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1447 HERBERT AVE",
"address_2": "SUITE 204",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961508976",
"telephone_number": "530-307-8554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1447 HERBERT AVE",
"address_2": "SUITE 204",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961508976",
"telephone_number": "530-307-8554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLOWATY",
"first_name": "THOMAS",
"middle_name": "LAWRENCE",
"name_prefix": "Mr.",
"credential": "M.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2010-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT13320",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NV",
"license": "5732-C",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "EPS015720",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in South Lake Tahoe, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.