Individual provider Active NPI

Ellen Kaye Dobbins, LICSW

  • Clinical Social Worker
  • Birmingham, AL
National Provider Identifier
1033617535
Registry record updated Feb 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2486C Issued in AL
Practice address
3504 Vann Rd # 100
Birmingham, AL 35235-3221
Phone
(205) 655-0585
NPI assigned
Jan 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2486C AL Primary

Addresses

Primary practice location

3504 Vann Rd # 100
Birmingham, AL 35235-3221

Mailing address

3504 Vann Rd # 100
Birmingham, AL 35235-3221
Phone (205) 655-0585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180504000296 AL Practitioner - Clinical Social Worker 3072877752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grayson and Associates PCGroup PAC ID 9032108253, 65 clinicians

Practice addresses (Care Compare)

3504 Vann Rd
Suite 100
Birmingham, AL 35235-3221
Phone (205) 655-0585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2486CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grayson and Associates PC Clinical CurrentSince Apr 1, 2018 Accepting new patients
SVPS Psychiatric Services LLC PastSince Apr 1, 2018 Accepting new patients

Locations

2200 Lakeshore Dr
Ste 150
Homewood, AL 35209
Phone (205) 397-4774

100 Concourse Pkwy
Ste 101
Hoover, AL 35244
Phone (205) 444-0420

3504 Vann Rd
#100
Trussville, AL 35235
Phone (205) 655-0585

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582329600000",
    "number": "1033617535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3504 VANN RD # 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353221",
            "telephone_number": "205-655-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 VANN RD # 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353221",
            "telephone_number": "205-655-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBBINS",
        "first_name": "ELLEN",
        "middle_name": "KAYE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-30",
        "last_updated": "2020-02-22",
        "certification_date": "2020-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "2486C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.