Healthcare Provider Details

I. General information

NPI: 1588261200
Provider Name (Legal Business Name): EMILY JO HOLLON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY CASSITY

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 MARTIN LUTHER KING JR BLVD
PARIS KY
40361-1281
US

IV. Provider business mailing address

4600 MONTGOMERY RD STE 400
CINCINNATI OH
45212-2600
US

V. Phone/Fax

Practice location:
  • Phone: 833-510-4357
  • Fax: 866-460-2997
Mailing address:
  • Phone: 833-510-4357
  • Fax: 866-460-2997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number260512
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: