DARA HOLLEY (NPI# 1770502502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770502502 |
| Entity Type | Individual |
| Full Name | DARA HOLLEY |
| Credential | LCSW |
| Practice Address |
4024 Central Ave St Petersburg FL 33711-1239 |
| Practice Telephone | 7273277656 |
| Practice Fax Number | 7273881192 |
| Mailing Telephone | 7273277656 |
| Mailing Fax Number | 7273881192 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2014-04-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
SW6192 | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 761752600 | 05 | |
| FL | MEDICARE | EY507Z | 01 |
| FL | FLORIDA HEALTH PARTNERS | F00545 | 01 |
| Street Address |
4024 CENTRAL AVE |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33711-1239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659371763 | Suncoast Center, Inc. | Clinic/Center | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2005-07-29 |
| 1790384709 | Tracy Reenae Hardaway | Counselor | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-10-21 |
| 1154928877 | Tyler Ray-baker | Counselor | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-10-06 |
| 1720694565 | Meghan Reese | Counselor | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-09-17 |
| 1720691595 | Georgette Franklin | Case Manager/Care Coordinator | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-08-31 |
| 1518570381 | Stephanie Ganoe | Counselor | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-08-31 |
| 1679181655 | April Irwin | Counselor | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-07-16 |
| 1497373757 | Mishania Jenkins | Case Manager/Care Coordinator | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-07-13 |
| 1154945632 | Kenneth Westerfield | Behavioral Analyst | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-06-01 |
| 1235753674 | Kathryn Ann Pinkston | Registered Nurse | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639665110 | Armando Alvarez Gonzalez | Nurse Practitioner | 3404 26th Ave S, St Petersburg, FL 33711 | 2018-07-08 |
| 1508398843 | S&r Cares LLC | Preferred Provider Organization | 4201 4th Avenue South Street, St Petersburg, FL 33711 | 2017-03-28 |
| 1245691062 | Brian Paulson | Counselor | 4024 Central Ave # 1239, Saint Petersburg, FL 33711 | 2016-03-08 |
| 1871966069 | Kelly Jean Plant | Home Health Aide | 3611 3rd Ave South, St Petersburg, FL 33711 | 2015-11-10 |
| 1750784815 | Honor Investments LLC | Community/Behavioral Health | 4750 Dophin Cay Ln S, #508, St Petersburg, FL 33711 | 2014-10-03 |
| 1063771947 | Vincent Ford | Physical Therapy Assistant | 3479 22nd Avenue, St.petersburg, FL 33711 | 2012-05-11 |
| 1568758571 | Ashley Lauren Taliaferro | Physical Therapist | 5042 42nd St S, Saint Petersburg, FL 33711 | 2011-06-28 |
| 1801180187 | Karen Lynn Wilcox | Massage Therapist | 2026 44th Street S, Saint Petersburg, FL 33711 | 2011-06-04 |
| 1881998722 | Martha L Allen | Assisted Living Facility | 1860 46 Street South, St. Petersburg, FL 33711 | 2011-01-07 |
| 1760519052 | Scg Palazzo Operator, LLC | Assisted Living Facility | 3600 34th St South, St Augustine, FL 33711 | 2007-02-27 |
| Find all providers in zip 33711 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073124582 | Nicholas Alexander Diaz | Social Worker | 1701 Central Ave Unit 251, St Petersburg, FL 33713-8971 | 2020-08-10 |
| 1255953444 | Olivia Bailey | Social Worker | 190 112th Ave N Apt 1129, St Petersburg, FL 33716-3269 | 2020-05-11 |
| 1417578295 | Grace Willms | Social Worker | 3530 1st Ave N Ste 111, St Petersburg, FL 33713-8422 | 2020-05-03 |
| 1730717638 | River Birch Wellness LLC | Social Worker | 4763 1st Ave S, St Petersburg, FL 33711-1005 | 2020-03-28 |
| 1740823400 | Resolution Today | Social Worker | 1700 Park St N Ste 109, St Petersburg, FL 33710-4300 | 2019-10-24 |
| 1992362735 | Rahim Samji | Social Worker | 3010 Fairfield Ave S, St Petersburg, FL 33712-1543 | 2019-05-28 |
| 1386133015 | Angela Ann Little | Social Worker | 920 Country Club Way S, St Petersburg, FL 33705 | 2018-05-08 |
| 1982109484 | Stefanie Von Ohlen LLC | Social Worker | 900 Central Ave # 302, St Petersburg, FL 33705-1647 | 2018-03-27 |
| 1306340112 | Premier Counseling and Wellness LLC | Social Worker | 3831 Tyrone Blvd N Ste 201c, St Petersburg, FL 33709-4114 | 2018-03-19 |
| 1184148439 | Christine Marie Pena | Social Worker | 209 9th Ave N, St Petersburg, FL 33701-1705 | 2017-07-28 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33711 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.