MEDICARE: MS. RACHEL ANNE HOLLAR LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	380	CO

General Provider Information

NPI Number	:	1801188651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RACHEL ANNE HOLLAR LCSW

Provider Business Mailing Address
First Line	:	1305 N EL PASO ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-2523
Country	:	US
Telephone Number	:	719-321-4856
Fax Number	:

Provider Business Practice Location Address
First Line	:	1852 IRWIN DR BLDG 1059
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4176
Country	:	US
Telephone Number	:	719-526-8154
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2011
Last Update Date	:	10/04/2023

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