Ellen M Walston

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C004573 Issued in NC

Practice address

3219 Landmark St Ste 7a
Greenville, NC 27834-7688

Phone

(252) 355-2801

Fax

(252) 355-4708

NPI assigned

Mar 1, 2007

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 3

Other names 1

• Ellen Mixon Walston Former name

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carenet IncGroup PAC ID 6406845262, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Carenet, Inc.

  • Mental Health Counselor
  • Winston Salem, NC
  • NPI 1043424013
  Medicare reassignment Care Compare group NPD
• Carenet, Inc.

  • Mental Health Counselor
  • Greenville, NC
  • NPI 1518170687
  NPD

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1245368273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3219 LANDMARK ST STE 7A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347688",
            "telephone_number": "252-355-2801",
            "fax_number": "252-355-4708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3219 LANDMARK ST STE 7A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347688",
            "telephone_number": "252-355-2801",
            "fax_number": "252-355-4708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSTON",
        "first_name": "ELLEN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002950",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D1613",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1358W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "WALSTON",
            "middle_name": "MIXON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carrie E Waller, M.D.
• Stephanie Wallio, PHD
• Eric Michael Walsh, CRT, RRT
• Katie M Walsh, EDD, ATC, LAT
• Christie Summerlin Walston, FNP
• Scarlett Jane Walston, DMD
• Walter B Jones Alcohol and Drug Abuse Treatment Center
• Walter B Jones Center Lakeside Psychiatric Hospital
• Walter B Jones Center Woodside Treatment Center
• Walter B Jones Center Woodside Treatment Center

• Clinical Social Worker in Greenville, NC
• Providers in Greenville, 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 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.