Michael Seward Ellis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C001135 Issued in NC

Practice address

107 Windel Dr Ste 213
Raleigh, NC 27609-4471

Phone

(919) 781-2750

Fax

(919) 477-6122

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174624951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WINDEL DR STE 213",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094471",
            "telephone_number": "919-781-2750",
            "fax_number": "919-477-6122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WINDEL DR STE 213",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094471",
            "telephone_number": "919-781-2750",
            "fax_number": "919-477-6122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MICHAEL",
        "middle_name": "SEWARD",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C001135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy Ellis, LCSWA
• Hannah Ellis
• Holly Lamb Ellis, SLP
• Hope Kaney Ellis
• Janifer Dorman Ellis, DDS
• Ronella N Ellis, MS, LMFT
• Tangela Ellis
• Ellison & Associates of Raleigh PC
• Brian Ellison, PHARM.D.
• Jenna Ellison, PHD

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.