Active NPI
Holly R. Warren, LCSW
- Clinical Social Worker
- Harrisburg, NC
National Provider Identifier
1821064759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C004155
- Practice address
- 4351 Main St
Suite 203
Harrisburg, NC 28075-7427 - Phone
- (704) 400-5158
- Fax
- (704) 455-7048
- NPI assigned
- Feb 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | C004155 | NC | Primary |
Addresses
Primary practice location
4351 Main St
Suite 203
Harrisburg, NC 28075-7427
Mailing address
6198 Roseway CT
Harrisburg, NC 28075-6509
Phone (704) 400-5158
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6003216 | Medicaid | NC |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C004155 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268265600000",
"number": "1821064759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6198 ROSEWAY CT",
"city": "HARRISBURG",
"state": "NC",
"postal_code": "280756509",
"telephone_number": "704-400-5158",
"fax_number": "704-455-7048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4351 MAIN ST",
"address_2": "SUITE 203",
"city": "HARRISBURG",
"state": "NC",
"postal_code": "280757427",
"telephone_number": "704-400-5158",
"fax_number": "704-455-7048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "HOLLY",
"middle_name": "R.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-28",
"last_updated": "2010-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C004155",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6003216",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Harrisburg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.