Ellyn Semchenko, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P020820 Issued in NC

Practice address

3000 Bethesda PL Ste 501
Winston Salem, NC 27103-3327

Phone

(336) 332-2277

NPI assigned

Jul 18, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Tides Counseling and Wellness, PLLC

  • Clinical Social Worker
  • High Point, NC
  • NPI 1790357622
  NPD (past)

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1609614072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4494 PIEDMONT TRACE DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274099200",
            "telephone_number": "701-836-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 BETHESDA PL STE 501",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033327",
            "telephone_number": "336-332-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMCHENKO",
        "first_name": "ELLYN",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P020820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larkin L Selman, MD
• Leilani Seltzer, LCSW
• Dez'Monee Selvey
• Sema4 Opco, Inc.
• Elliott L Semble, M.D.
• Taras Semchyshyn
• Charles Thomas Alexander Semelka, MD
• Luke Seminara, NP AGACNP-BC
• Sanchala Sen
• James Alan Senft, MD

• Clinical Social Worker in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.