Ellie Suzanne Poulis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2007036195 Issued in MO

Practice address

14377 Woodlake Dr
Suite 308
Chesterfield, MO 63017-5735

Phone

(314) 576-6493

Fax

(314) 576-7319

NPI assigned

May 28, 2008

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1427216225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14377 WOODLAKE DR",
            "address_2": "SUITE 308",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175735",
            "telephone_number": "314-576-6493",
            "fax_number": "314-576-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14377 WOODLAKE DR",
            "address_2": "SUITE 308",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175735",
            "telephone_number": "314-576-6493",
            "fax_number": "314-576-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULIS",
        "first_name": "ELLIE",
        "middle_name": "SUZANNE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2007036195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katey Elayne Pope
• Kayla Elizabeth Portwood Luker, FNP
• Jaimie A Poston, CCC-SLP
• Emmanuel Potsos, D.C.
• Lindsey Potts, OT
• Eileen Powers-Pate, DC
• Hannah Powers
• Julie A. Pozzoli, RD, LD, CDE
• Practice of Alan Spivack, LLC
• Christian Arturo Prada, M.D.

• Clinical Social Worker in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; 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.