Holly R Wickham, LMSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801113476 Issued in MI

Practice address

550 Stephenson Hwy Ste 200
Troy, MI 48083-1132

Phone

(239) 848-2087

NPI assigned

Sep 14, 2021

Last updated

Nov 3, 2023By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• River's Bend, P.C.

  • Addiction (Substance Use Disorder) Counselor
  • Troy, MI
  • NPI 1265520209
  NPD (past)

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1972273746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 HATCHER CIR UNIT 210",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288060498",
            "telephone_number": "239-848-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 STEPHENSON HWY STE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831132",
            "telephone_number": "239-848-2087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 Hatcher Cir Unit 210",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288060498",
            "country_code": "US",
            "telephone_number": "239-848-2087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICKHAM",
        "first_name": "HOLLY",
        "middle_name": "R",
        "credential": "LMSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016262",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801113476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Whitefoot
• Marissa Blair Whitford, LLPC
• Alice M Whitmore
• Alyce Whittico
• Hannah Elizabeth Wickersham, DPT
• Donna Marie Widman, MA, LPC
• Alyssia Wieczorkowski
• Bethany Wieske
• Paul Wieske
• Heidi Wiest, CRNA

• Clinical Social Worker in Troy, MI
• Providers in Troy, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.