Active NPI
Tammy Kendal Ellison, LCSW
- Behavior Analyst
- Albuquerque, NM
National Provider Identifier
1033447354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- C-08200
- Practice address
- 2765 Wolfberry PL NE
Albuquerque, NM 87122-1228 - Phone
- (505) 401-4088
- Fax
- (505) 899-4508
- NPI assigned
- Nov 24, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | C-08200 | NM | Primary |
Addresses
Primary practice location
2765 Wolfberry PL NE
Albuquerque, NM 87122-1228
Mailing address
2765 Wolfberry PL NE
Albuquerque, NM 87122-1228
Phone (505) 401-4088
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160421001063 | NM | Practitioner - Clinical Social Worker | 6709184971 | Practice locations: Albuquerque, NM |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2765 Wolfberry PL NE
Albuquerque, NM 87122-1228
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X-06814 | NM | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781136000000",
"number": "1033447354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2765 WOLFBERRY PL NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871221228",
"telephone_number": "505-401-4088",
"fax_number": "505-298-7380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2765 WOLFBERRY PL NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871221228",
"telephone_number": "505-401-4088",
"fax_number": "505-899-4508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "TAMMY",
"middle_name": "KENDAL",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-24",
"last_updated": "2026-06-11",
"certification_date": "2026-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NM",
"license": "C-08200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.