Active NPI
Ellaree Louise Simpson, LISW-S,LICOC, MSSA
- Clinical Social Worker
- Reynoldsburg, OH
National Provider Identifier
1245660752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.1201237-SUPV
- Practice address
- 7654 Slate Ridge Blvd.
Reynoldsburg, OH 43068 - Phone
- (614) 523-6629
- Fax
- (866) 820-4098
- NPI assigned
- Nov 19, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 956835 | OH | |
| Clinical Social Worker | 1041C0700X | I.1201237-SUPV | OH | Primary |
Addresses
Primary practice location
7654 Slate Ridge Blvd.
Reynoldsburg, OH 43068
Mailing address
7654 Slate Ridge Blvd.
Reynoldsburg, OH 43068
Phone (614) 626-2696
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 956835 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| I.1201237-SUPV | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384819200000",
"number": "1245660752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7654 SLATE RIDGE BLVD.",
"city": "REYNOLDSBURG",
"state": "OH",
"postal_code": "43068",
"telephone_number": "614-626-2696",
"fax_number": "866-820-4098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7654 SLATE RIDGE BLVD.",
"city": "REYNOLDSBURG",
"state": "OH",
"postal_code": "43068",
"telephone_number": "614-523-6629",
"fax_number": "866-820-4098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMPSON",
"first_name": "ELLAREE",
"middle_name": "LOUISE",
"name_prefix": "Ms.",
"credential": "LISW-S,LICOC, MSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-19",
"last_updated": "2013-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "956835",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.1201237-SUPV",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reynoldsburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.