Anderson, Holly

Anderson, Holly is an individual health care provider with primary practice located at 1 E 22Nd St Suite 310, Lombard IL 60148-6159. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Anderson, Holly can be contacted via phone (417) 291-8612.

Contact Information

Primary practice address
1 E 22Nd St Suite 310 Lombard IL 60148-6159
Phone: (417) 291-8612
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X 149.018939 Illinois
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149018939 Illinois

Profile Details

NPI number 1841725504
LBN Legal business name Anderson, Holly
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2017
Last updated Mar 6th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841725504 NPPES
Illinois MEDICAID 1041C0700X

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