Carolyn Hollister, LISW | |
1605 N Ankeny Blvd Ste 110, Ankeny, IA 50023-4163 | |
(515) 520-8164 | |
(515) 209-7756 |
Full Name | Carolyn Hollister |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 1605 N Ankeny Blvd Ste 110, Ankeny, Iowa |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1932778610 | NPI | - | NPPES |
107365 | Other | IA | SOCIAL WORK LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 107365 (Iowa) | Primary |
Entity Name | Illuminate Life Therapy, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194408500 PECOS PAC ID: 9638525686 Enrollment ID: O20231026002391 |
Mailing Address | Practice Location Address |
---|---|
Carolyn Hollister, LISW 1605 N Ankeny Blvd Ste 110, Ankeny, IA 50023-4163 Ph: (515) 402-1047 | Carolyn Hollister, LISW 1605 N Ankeny Blvd Ste 110, Ankeny, IA 50023-4163 Ph: (515) 520-8164 |
Mrs. Susan Elizabeth Price Saylor, LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 2525 N Ankeny Blvd, Ste 113, Ankeny, IA 50023 Phone: 515-289-9136 Fax: 515-289-9139 | |
Abbey Shell, LISW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 614 Nw Wagner Ridge Ct, Ankeny, IA 50023 Phone: 515-423-0019 | |
Leisha R Ristau, LISW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2425 N Ankeny Blvd Ste 106, Ankeny, IA 50023 Phone: 515-489-4602 Fax: 515-512-1504 | |
Kay Foster, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1609 N Ankeny Blvd, Ste 210, Ankeny, IA 50023 Phone: 515-953-9256 | |
Kalee Culver, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1105 N Ankeny Blvd Ste 100, Ankeny, IA 50023 Phone: 866-953-3495 | |
Mr. John Terry Fandrich, LISW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 501 Sw Ankeny Rd, Ankeny, IA 50023 Phone: 515-289-2272 Fax: 515-289-0126 | |
Hannah Rose Nelson, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1105 N Ankeny Blvd Ste 100, Ankeny, IA 50023 Phone: 515-255-8399 |