Lori Ellis

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW7158 Issued in FL

Legal business name

LORI ELLIS

Practice address

2861 Executive Dr
Clearwater, FL 33762-2264

Phone

(727) 631-5959

NPI assigned

Apr 11, 2017

Last updated

Apr 11, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lori Ellis, LCSW

Title

Owner

Phone

(727) 631-5959

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1184157687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2861 EXECUTIVE DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337622264",
            "telephone_number": "727-631-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 EXECUTIVE DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337622264",
            "telephone_number": "727-631-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORI ELLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-631-5959",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria Patricia Lopez, MSN, APRN, FNP-BC
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• Curt Lord, PRACTICAL NURSE
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• Sarah Michelle Loupe
• Lourdes T Santiago M D P a

• Clinical Social Worker in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.