| Holly Maddy, Llc | |
|
328 Thomas More Pkwy Unit 102 Crestview Hills KY 41017-3488 | |
| (859) 431-6333 | |
| Not Available |
| Full Name | Holly Maddy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 328 Thomas More Pkwy, Crestview Hills, Kentucky |
| Authorized Official Name and Position | Holly Ann Maddy (OWNER) |
| Authorized Official Contact | 8594316333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holly Maddy, Llc 328 Thomas More Pkwy Unit 102 Crestview Hills KY 41017-3488 Ph: (859) 431-6333 | Holly Maddy, Llc 328 Thomas More Pkwy Unit 102 Crestview Hills KY 41017-3488 Ph: (859) 431-6333 |
| NPI Number | 1154586394 |
|---|---|
| Provider Enumeration Date | 07/28/2008 |
| Last Update Date | 11/10/2023 |
| Certification Date | 11/10/2023 |
| Medicare PECOS PAC ID | 2365503968 |
|---|---|
| Medicare Enrollment ID | O20081201000452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154586394 | NPI | - | NPPES |
| 82001017 | Medicaid | KY | |
| 7100924470 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Holly Ann Maddy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912078650 PECOS PAC ID: 0840277612 Enrollment ID: I20040630000857 |
| Provider Name | Mark S Switzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174954176 PECOS PAC ID: 0840509246 Enrollment ID: I20180419001589 |
| Provider Name | Anna Patton-lingeman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972923480 PECOS PAC ID: 5597193318 Enrollment ID: I20200310000861 |
| Provider Name | Kerry Schafer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568045748 PECOS PAC ID: 5092114959 Enrollment ID: I20210525002884 |
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