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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

HOLLY MARIE WYNN LCSW
NPI 1902419658
Social Worker - Clinical in Idaho Falls, ID

Active since August 24, 2020PECOS Enrolled
254 E ST STE B, IDAHO FALLS, ID 83402(208) 529-1854(208) 523-5974 Get Directions Write a Review

NPPES record last updated: October 7, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 7, 2026, Nov 26, 2025, Nov 12, 2025 and 1 more (4 updates tracked since 2020).

About Holly Marie Wynn Lcsw NPPES

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

HOLLY MARIE WYNN LCSW (NPI 1902419658) is an individual clinical provider in Idaho Falls, Idaho, licensed in Idaho (8911052) and active in the NPI registry since August 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902419658
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameHOLLY MARIE WYNNCredential: LCSW
Location Address254 E ST STE BIdaho Falls, ID 83402
Mailing Address254 E St Ste BIdaho Falls, ID 83402 · (208) 529-1854 · Fax (208) 523-5974
Phone(208) 529-1854
Fax(208) 523-5974
Sole ProprietorNo
Enumeration DateAugust 24, 2020
Last NPPES UpdateOctober 7, 20264 updates tracked since enumeration
NPPES CertifiedOctober 7, 2026
✔ NPI 1902419658 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in ID · 8911052
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.
254 E ST STE B, Idaho Falls, ID 83402
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Other Names 1

Former Name (1)Holly Marie Cruz

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Holly Marie Wynn Lcsw 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 Holly Wynn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Joshua D Smith And Associates Inc
14 mi
Community/Behavioral Health
540 3RD ST
Idaho Falls, ID 83401
  • Reassigned Medicare billing, Idaho enrollment
  • 6 clinicians in this Medicare group
NPI 1144351461 (208) 529-3719

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 83402 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 $52.44 – $160.17
Typical copayment $0.00 (range $13.11 – $40.04)
Most-billed visit code NA
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
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.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LOGAN RHETT TINGEY
Social Worker
254 E ST STE B
IDAHO FALLS, ID 83402
Bonneville County (208) 483-1813
CRAIG PERRELL
Social Worker
254 E ST STE B
IDAHO FALLS, ID 83402
Bonneville County (208) 529-1854
JULIA BOOKER
Case Manager/Care Coordinator
254 E ST STE B
IDAHO FALLS, ID 83402
Bonneville County (208) 529-1854
JENNIFER CAILLIER
Counselor (Addiction (Substance Use Disorder))
254 E ST STE B
IDAHO FALLS, ID 83402
Bonneville County (208) 529-1854
TERIANN NESS LCSW
Social Worker (Clinical)
254 E ST STE B
IDAHO FALLS, ID 83402
Bonneville County (208) 529-1854
MRS. JESSICA OWSLEY LCSW
Social Worker (Clinical)
254 E ST STE B
IDAHO FALLS, ID 83402
Bonneville County (208) 529-1854
MS. MICHELLE LEJUNE PERRENOUD LCSW
Social Worker (Clinical)
254 E ST STE B
IDAHO FALLS, ID 83402
Bonneville County (208) 351-7953
RHONDA THOMPSON LCSW
Social Worker (Clinical)
254 E ST STE B
IDAHO FALLS, ID 83402
Bonneville County (208) 529-1854

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 Holly Wynn's NPI number?

The NPI number for Holly Wynn is 1902419658. It was assigned to this individual provider in the NPPES registry on August 24, 2020. The provider is also known as Holly Marie Cruz.

Where is Holly Wynn located?

Holly Wynn practices at 254 E St Ste B, Idaho Falls, ID 83402. The listed phone number is (208) 529-1854.

What is Holly Wynn's specialty?

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

Is Holly Wynn enrolled in Medicare?

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

Which organization bills Medicare for Holly Wynn's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Holly Wynn reassigns Medicare benefits to Joshua D Smith And Associates Inc (Idaho Falls, ID). 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 Holly Wynn'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 Holly Wynn was last updated on October 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days 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.