Active NPI
Courtney Hollway, LCSW
- Clinical Social Worker
- Tahoe City, CA
National Provider Identifier
1811288079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 26393
- Practice address
- 2690 Lake Forest Rd
Tahoe City, CA 96145-7322 - Phone
- (530) 581-4054
- NPI assigned
- Apr 22, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 26393 | CA | Primary |
Addresses
Primary practice location
2690 Lake Forest Rd
Tahoe City, CA 96145-7322
Mailing address
PO Box 7322
Tahoe City, CA 96145-7322
Phone (530) 581-4054
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 |
|---|---|---|---|
| 26393 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303430400000",
"number": "1811288079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7322",
"city": "TAHOE CITY",
"state": "CA",
"postal_code": "961457322",
"telephone_number": "530-581-4054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2690 LAKE FOREST RD",
"city": "TAHOE CITY",
"state": "CA",
"postal_code": "961457322",
"telephone_number": "530-581-4054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLWAY",
"first_name": "COURTNEY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-22",
"last_updated": "2011-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "26393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tahoe City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.