Melanie S Ellerbrock, LISW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I00009232 Issued in OH

Practice address

715 Lane Street
Coal Grove, OH 45638

Phone

(740) 354-7702

Fax

(740) 353-1662

NPI assigned

Dec 5, 2006

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

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.

• Shawnee Mental Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Portsmouth, OH
  • NPI 1336777077
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1154489979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1507",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "45662",
            "telephone_number": "740-354-7702",
            "fax_number": "740-353-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 LANE STREET",
            "city": "COAL GROVE",
            "state": "OH",
            "postal_code": "45638",
            "telephone_number": "740-354-7702",
            "fax_number": "740-353-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLERBROCK",
        "first_name": "MELANIE",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I00009232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0200599",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randi Drummond
• Stacey P Dulaney, CDCA
• Amy Lynn Dunlap
• Mercedes Dunlap, CDCA
• Matthew Seth Egan, FNP-BC
• Shannon Noel Ellis, LICDC.162092
• Sara Elswick
• Teresa Ervin, CMS
• Joseph Evans
• Beulah Felty, CDCA.184727

• Social Worker in Coal Grove, OH
• Providers in Coal Grove, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.