Holly Anderson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149018939 Issued in IL

Practice address

1 E 22ND St
Suite 310
Lombard, IL 60148-6159

Phone

(417) 291-8612

NPI assigned

May 1, 2017

Last updated

Mar 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614988800000",
    "number": "1841725504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E 22ND ST",
            "address_2": "SUITE 310",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486159",
            "telephone_number": "417-291-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E 22ND ST",
            "address_2": "SUITE 310",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486159",
            "telephone_number": "417-291-8612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "HOLLY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2021-03-06",
        "certification_date": "2021-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018939",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "IL",
            "license": "149.018939",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041C0700X",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sanjay J Amin, M.D.
• Amoteks Inc
• Amr Enterprises LLC
• Cassidy Ancira
• Chloe Anderson, CCC-SLP
• Reagan Anderson
• Robert Anderson
• Julie Andreas, DPM
• Julia C Andreoni, M.D.
• Andrew a. Roth, M.D.,S.C. (Yorktown Health)

• Clinical Social Worker in Lombard, IL
• Providers in Lombard, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2021; 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.