Individual provider Active NPI

Thomas Lawrence Hollowaty, M.S.W.

  • Clinical Social Worker
  • South Lake Tahoe, CA
National Provider Identifier
1740348259
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5732-C Issued in NV
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

Updated by the provider on Aug 9, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
EPS015720MedicaidCA

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

LicenseStateTypeSpecialty
5732-CNVMDClinical Social Worker
MFT13320CAMDMarriage & 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.

Verify at the official NPI Registry.