Individual provider Active NPI

Elois Wells, LCSW-R

  • Clinical Social Worker
  • New Hartford, NY
National Provider Identifier
1184773145
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R052669-1 Issued in NY
Practice address
4277 Middle Settlement Rd
New Hartford, NY 13413-5315
Phone
(315) 735-6484
Fax
(315) 735-8545
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R052669-1 NY Primary

Addresses

Primary practice location

4277 Middle Settlement Rd
New Hartford, NY 13413-5315

Mailing address

461 Ashwood Ave
Utica, NY 13502-1815
Phone (315) 735-1612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R052669-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice & Palliative Care Inc PastSince Sep 4, 2018 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184773145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 ASHWOOD AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135021815",
            "telephone_number": "315-735-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4277 MIDDLE SETTLEMENT RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134135315",
            "telephone_number": "315-735-6484",
            "fax_number": "315-735-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "ELOIS",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R052669-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

  • 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.