Organization Active NPI

Holo Wellness LLC

  • Clinical Social Worker
  • Orlando, FL
National Provider Identifier
1811407356
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14831 Issued in FL
Legal business name
HOLO WELLNESS LLC
Practice address
5401 S Kirkman Rd Ste 310
Orlando, FL 32819-7937
Phone
(407) 839-9152
NPI assigned
Oct 11, 2017
Last updated
Oct 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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

Authorized official

Name
Mrs. Ashley Nicole Morris, LCSWNPI 1972869261
Title
Owner/Psychotherapist
Phone
(407) 839-9152

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X SW14831 FL Primary

Addresses

Primary practice location

5401 S Kirkman Rd Ste 310
Orlando, FL 32819-7937

Mailing address

7813 Sugar Brook CT
Orlando, FL 32819-7210
Phone (773) 484-8538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180907002455 FL Part B Supplier - Clinic/Group Practice 4688924814 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507680000000",
    "number": "1811407356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7813 SUGAR BROOK CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197210",
            "telephone_number": "773-484-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 S KIRKMAN RD STE 310",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197937",
            "telephone_number": "407-839-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLO WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-10-11",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "407-839-9152",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.