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ETHLYN HOLLY
NPI 1043694888
Social Worker - Clinical in Greensboro, MD

Active since July 10, 2015PECOS Enrolled
101 S ACADEMY ST, GREENSBORO, MD 21639(410) 404-4625 Get Directions Write a Review

NPPES record last updated: November 29, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ethlyn Holly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHLYN HOLLY (NPI 1043694888) is an individual clinical provider in Greensboro, Maryland and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043694888
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameETHLYN HOLLY
Location Address101 S ACADEMY STGreensboro, MD 21639-1643
Mailing AddressPo Box 29Greensboro, MD 21639-0029 · (410) 404-4625
Phone(410) 404-4625
Sole ProprietorNo
Enumeration DateJuly 10, 2015
Last NPPES UpdateNovember 29, 2023
NPPES CertifiedNovember 29, 2023
✔ NPI 1043694888 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedSocial WorkerTaxonomy 104100000X · License 17713 (MD)
101 S ACADEMY ST, Greensboro, MD 21639
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethlyn Holly is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ethlyn Holly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PA
945 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, District of Columbia enrollment
  • 1,424 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21639 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $57.99 – $175.57
Typical copayment $0.00 (range $14.49 – $43.89)
Most-billed visit code NA
Established Patient
$72.23 typical visit price
range $18.66 – $143.02
Typical copayment $18.05 (range $4.66 – $35.75)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethlyn Holly's NPI number?

The NPI number for Ethlyn Holly is 1043694888. It was assigned to this individual provider in the NPPES registry on July 10, 2015.

Where is Ethlyn Holly located?

Ethlyn Holly practices at 101 S Academy St, Greensboro, MD 21639. The listed phone number is (410) 404-4625.

What is Ethlyn Holly's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Ethlyn Holly enrolled in Medicare?

Yes. Ethlyn Holly is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ethlyn Holly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethlyn Holly reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ethlyn Holly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ethlyn Holly was last updated on November 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.