Look up the most recent NPI and PECOS records

Kelli Nicole Holloway

Social Worker

Behavioral Health & Social Service Providers

PECOS Enrollment

This provider is enrolled in PECOS as KELLI HOLLOWAY.

Based on the most recent information from CMS, provider Kelli Nicole Holloway is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1720598295
Provider Type
Individual
Full Name
Holloway, Kelli Nicole
Credential
LCSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
10/10/2017
Last Updated
3/28/2025

Contact Information

Practice Location

1548 Poplar Ave, Memphis, TN 38104-2432

(901) 272-0855

(901) 333-8255

Mailing Location

4844 Bloomfield Dr, Memphis, TN 38125-3356

(901) 215-8602

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License Unlisted Issuer

Kelli Nicole Holloway

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Henderson, Rachael

Wenzel, Seth A

Powell, Erica

Cannon, John Clark

Barton, Sheila Judge

Byrd, Elizabeth B

Owens, Jacquelyn Ann

Christian Counseling And Consulting, Llc

Towler, Susan Ann

Frazer, Katherine Marie