Rachel Ellis, LCSW, SAC-IT

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1015 Gammon LN
Madison, WI 53719-2210

Phone

(608) 417-8162

NPI assigned

May 19, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Meriter Hospital, Inc.

  • Psychiatric Hospital Unit
  • Madison, WI
  • NPI 1548280225
  Medicare reassignment NPD
• Meriter Hospital, Inc.

  • General Practice Physician
  • Madison, WI
  • NPI 1932572955
  NPD
• Maleck Therapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
  • NPI 1114480878
  NPD (past)

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1154068229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 GAMMON LN",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537192210",
            "telephone_number": "608-417-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 GAMMON LN",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537192210",
            "telephone_number": "608-417-8162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Ray O Vac Dr Ste 114",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537112468",
            "country_code": "US",
            "telephone_number": "608-598-9127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "RACHEL",
        "credential": "LCSW, SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-19",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "11565-123",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "endpointDescription": "EPIC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1015 Gammon Ln",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537192210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrick S Elliott, DDS
• Caitlin Ellis, LPC
• Christine Ellis, M.A., M.S., LPC
• Gayle M. Ellis
• Molly Ellis, RD, DC
• Richard L Ellis, MD
• Ashli L Ellison, NP
• Elizabeth Laurie Ellison, MS LMFT
• Matthew Christian Ellison, DPT
• Max Evan Weintraub Ellithorpe, MD

• Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.