Ellen Dodge, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

003078 Issued in CT

Practice address

186 Blood St
Lyme, CT 06371-3507

Phone

(860) 460-0488

NPI assigned

Apr 16, 2007

Last updated

Jan 2, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CT

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, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1346465200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 BLOOD ST",
            "city": "LYME",
            "state": "CT",
            "postal_code": "063713507",
            "telephone_number": "860-460-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 BLOOD ST",
            "city": "LYME",
            "state": "CT",
            "postal_code": "063713507",
            "telephone_number": "860-460-0488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "567 Vauxhall Street Ext",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "CT",
            "postal_code": "063854330",
            "country_code": "US",
            "telephone_number": "860-460-0488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DODGE",
        "first_name": "ELLEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "003078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Valerie T Keating, PSYD
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• Lauren Alyssa Paterson
• Paula K. Signora, MS, CCC/SLP

• Clinical Social Worker in Lyme, CT
• Providers in Lyme, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.