Ellen L.H. Malone, LISW, LCSW, ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C2571 Issued in MS

Practice address

1408 Highway 90
Suite 2
Gautier, MS 39553-5456

Phone

(228) 497-8180

Fax

(228) 497-6594

NPI assigned

Jun 16, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Ms. Ellen Louise Hamilton Payne Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1487659397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1512",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395530019",
            "telephone_number": "228-497-8180",
            "fax_number": "228-497-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 HIGHWAY 90",
            "address_2": "SUITE 2",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535456",
            "telephone_number": "228-497-8180",
            "fax_number": "228-497-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "ELLEN",
        "middle_name": "L.H.",
        "credential": "LISW, LCSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000001199",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0003297",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C2571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00802799",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "PAYNE",
            "middle_name": "LOUISE HAMILTON",
            "prefix": "MS.",
            "credential": "M.S.S.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Channon Rebecca Lytton, E.DD.
• Kimberlie La'Tasha Mabry, FNP-C
• Ebbie Larhonda Maddox, LMSW
• Magnolia Occupational & Physical Therapy, LLC
• Loggan Malone Weihe, DMD
• Amber Nicole Mapp, BA
• David Wesley Marks, BS PSYCHOLOGY
• Bessie L Marshall, BS
• Riyana Marshall
• Fredericka L Mason

• Clinical Social Worker in Gautier, MS
• Providers in Gautier, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.