Individual provider · Type 1 NPI

Holly Marie Wynn, LCSW

Clinical Social Worker · Idaho Falls, ID

NPI number 1902419658 Active

Practice location

254 E St Ste B
Idaho Falls, ID 83402

Call (208) 529-1854 Map

Fax (208) 523-5974

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X8911052 (ID)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1902419658

Holly Marie Wynn, LCSW's National Provider Identifier is 1902419658, issued on Aug 24, 2020. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Idaho Falls, ID. The record was last updated on Oct 7, 2026.