MEDICARE: CALEB HOLLIMAN 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	SW24201	FL

General Provider Information

NPI Number	:	1760288096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALEB HOLLIMAN LCSW

Provider Business Mailing Address
First Line	:	1317 WHITCOMBE DR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-8376
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1317 WHITCOMBE DR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-8376
Country	:	US
Telephone Number	:	816-872-4828
Fax Number	:

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

Provider Enumeration Date	:	02/19/2025
Last Update Date	:	02/19/2025

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