Holly Yvonne Mancillas, LSCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

06264 Issued in KS

Practice address

712 Saint John St
Garden City, KS 67846-5128

Phone

(620) 275-1766

Fax

(620) 275-4729

NPI assigned

Apr 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KS

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1740801885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 SAINT JOHN ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678465128",
            "telephone_number": "620-275-1766",
            "fax_number": "620-275-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 SAINT JOHN ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678465128",
            "telephone_number": "620-275-1766",
            "fax_number": "620-275-4729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCILLAS",
        "first_name": "HOLLY",
        "middle_name": "YVONNE",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "06264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hmancillas@genesisfh.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "712 Saint John St",
            "city": "Garden City",
            "state": "KS",
            "country_code": "US",
            "postal_code": "678465128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diane M Madsen, CRMA
• Erma R Magie, AAPS
• Esmeralda Main, LPC
• Jay D Main, D.D.S.
• Mahmud Ul Majeed, MD
• Edward L Mangosing, M.D.
• Abeera Mansur, MD
• Joseph Heinrick Marceny, MD
• Brittany Marie Martin
• Linda A Martin, M.D.

• Clinical Social Worker in Garden City, KS
• Providers in Garden City, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.