Ellisa Lee
Individual provider Active NPI Clinical Social Worker · Spencer, OK
NPI 1215401708 · NPPES record last updated Jun 22, 2026
Key facts
- NPI
- 1215401708
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 8248 (OK)
- Practice address
- 2601 Spencer Rd
Spencer, OK 73084-3649 - Phone
- (405) 824-6432
- NPI assigned
- Jan 17, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8248 | OK | MD | Clinical Social Worker |
| 6878 | OK | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8248 | OK | Yes |
| Mental Health Counselor | 101YM0800X | 8248 | OK |
Addresses
Primary practice location
2601 Spencer Rd
Spencer, OK 73084-3649
Mailing address
2601 Spencer Rd
Spencer, OK 73084-3649
Phone (405) 824-6432
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200817140A | Medicaid | OK |
Other providers in Spencer, OK
- Janice Kemp
- Jennifer Kennedy
- Patrick James Kennedye
- Rebecca Leah Kropfinger
- Norva Lynn Larney
- Shameka Denise Lee
- Angela Jeanette Lewis
- Ladora Lightner
- Tiffany P Linzy
- Glenda Long
All providers in Spencer, OK · Clinical Social Worker in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.