Individual provider Active NPI

Ying P Elliott, LICSW

  • Clinical Social Worker
  • Plymouth, MN
National Provider Identifier
1144213901
Registry record updated Jul 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14561 Issued in MN
Practice address
10700 Old County Road 15 Ste 170
Plymouth, MN 55441-8709
Phone
(763) 525-8590
Fax
(763) 525-8592
NPI assigned
Aug 26, 2005
Last updated
Jul 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2023

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 14561 MN Primary

Addresses

Primary practice location

10700 Old County Road 15 Ste 170
Plymouth, MN 55441-8709

Mailing address

10700 Old County Road 15 Ste 170
Plymouth, MN 55441-8709
Phone (763) 525-8590

Other identifiers 1

IdentifierTypeStateIssuer
891493100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20050804001075 MN Practitioner - Clinical Social Worker 1658300157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Pathways Psychological Services PAGroup PAC ID 9133161672, 7 clinicians

Practice addresses (Care Compare)

10700 Old County Rd
15 Suite 170
Plymouth, MN 55441-8709
Phone (763) 525-8590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Psychological Services, P.a. CurrentSince Feb 14, 2011 Accepting new patients

Locations

7575 Golden Valley Rd
Ste 230
Minneapolis, MN 55427
Phone (763) 525-8590

10700 Old County Road 15
Ste 170
Plymouth, MN 55441
Phone (763) 525-8590

5354 Edgewood Dr
Saint Paul, MN 55112

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688169600000",
    "number": "1144213901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 OLD COUNTY ROAD 15 STE 170",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554418709",
            "telephone_number": "763-525-8590",
            "fax_number": "763-525-8592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 OLD COUNTY ROAD 15 STE 170",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554418709",
            "telephone_number": "763-525-8590",
            "fax_number": "763-525-8592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "YING",
        "middle_name": "P",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2023-07-01",
        "certification_date": "2023-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "14561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891493100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.