Ellen Fitzgerald-McCallum, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW02290 Issued in RI

Practice address

1443 Hartford Ave
Johnston, RI 02919-3224

Phone

(401) 273-8100

Fax

(401) 861-8696

NPI assigned

Mar 11, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1104149616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 HARTFORD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193224",
            "telephone_number": "401-273-8100",
            "fax_number": "401-861-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 HARTFORD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193224",
            "telephone_number": "401-273-8100",
            "fax_number": "401-861-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD-MCCALLUM",
        "first_name": "ELLEN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-11",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GH57134",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher A Ferri, D.O
• Fred Ferri, MD
• Vito F. Ferri, D.O.
• Leonora First, MD
• Ryan Fish, LICSW
• Claudia S Flobil Heredia, PT,DPT
• Laura Lee Flynn, D.M.D.
• Alyson Franz, LICSW
• Denise A Franzese, DC
• Frederick M Johnson MD Inc

• All providers in Johnston, RI
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.