MEDICARE: EMILY HOLLIS 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	12069-C	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871229690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY HOLLIS LCSW

Provider Business Mailing Address
First Line	:	1707 LINWOOD DR STE B
Second Line	:
City	:	PARAGOULD
State	:	AR
Zip	:	72450-5365
Country	:	US
Telephone Number	:
Fax Number	:	888-977-2956

Provider Business Practice Location Address
First Line	:	106 RIDGEWAY ST STE A&B
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901-7198
Country	:	US
Telephone Number	:	501-389-8100
Fax Number	:	888-977-2956

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

Provider Enumeration Date	:	07/25/2022
Last Update Date	:	11/18/2025

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Directions to “ EMILY HOLLIS LCSW” Practice Location

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