Individual provider Active NPI

Tellie Ruffin, LCSW

  • Clinical Social Worker
  • Wilmington, DE
National Provider Identifier
1447602859
Registry record updated Jul 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW017016 Issued in PA
Practice address
2005 Baynard Blvd
Wilmington, DE 19802-3917
Phone
(302) 650-3151
Fax
(855) 295-5274
NPI assigned
Jul 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW017016 PA Primary

Addresses

Primary practice location

2005 Baynard Blvd
Wilmington, DE 19802-3917

Mailing address

2005 Baynard Blvd
Wilmington, DE 19802-3917
Phone (302) 650-3151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160915000153 PA Practitioner - Clinical Social Worker 1557657756 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW017016PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. Current Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Oct 1, 2016 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Oct 1, 2016 Accepting new patients

Locations

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1468022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468022400000",
    "number": "1447602859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 BAYNARD BLVD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198023917",
            "telephone_number": "302-650-3151",
            "fax_number": "855-295-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 BAYNARD BLVD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198023917",
            "telephone_number": "302-650-3151",
            "fax_number": "855-295-5274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFIN",
        "first_name": "TELLIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-09",
        "last_updated": "2016-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.