JESSICA ELIZABETH HOLLY LICSW
NPI 1457636615
Social Worker - Clinical in Minneapolis, MN
NPI Status: Active since October 19, 2011
Contact Information
1100 GLENWOOD AVE
MINNEAPOLIS, MN
ZIP 55405
Phone: (612) 871-1454
Fax: (612) 871-1505
- Individual
- Female
- Social Worker
- Clinical
- Opted-Out Medicare
About JESSICA HOLLY
This page provides the complete NPI Profile along with additional information for Jessica Holly, a provider established in Minneapolis, Minnesota with a medical specialization in Social Worker, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1457636615 assigned on October 2011. The practitioner's primary taxonomy code is 1041C0700X with license number 19721 (MN). The provider is registered as an individual and her NPI record was last updated 12 years ago.
- NPI
- 1457636615
- Provider Name
- JESSICA ELIZABETH HOLLY LICSW
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1100 GLENWOOD AVE MINNEAPOLIS, MN 55405
- Location Phone
- (612) 871-1454
- Location Fax
- (612) 871-1505
- Mailing Address
- 1100 GLENWOOD AVE MINNEAPOLIS, MN 55405
- Mailing Phone
- (612) 871-1454
- Mailing Fax
- (612) 871-1505
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-19-2011
- Last Update Date
- 12-03-2014
- Code Navigator
A clinical social worker like Jessica Holly is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Jessica Holly opted out of Medicare effective on 04-01-2022 until 04-01-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Social Worker Clinical
- Taxonomy Code
- 1041C0700X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 19721
- License State
- MN
- Taxonomy Description
- 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.
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-01-2022
Opt-Out End Date: 04-01-2026
Eligible to Order and Refer? No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1457636615, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MINNEAPOLIS, MN 55405
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1457636615, enumerated as an "individual" on October 19, 2011.
The provider is located at 1100 GLENWOOD AVE MINNEAPOLIS, MN 55405 and the phone number is (612) 871-1454.
Social Worker with taxonomy code 1041C0700X and a focus in Clinical.
