Dawn Elaine Ellicott Clinkscale, LMFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

MT3549 Issued in FL

Practice address

4700 N State Road 7
Lauderdale Lakes, FL 33319-5800

Phone

(954) 634-8096

NPI assigned

Sep 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dawnellicottclinkscale@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD
• Henderson Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Lauderdale Lakes, FL
  • NPI 1972533271
  NPD (past)

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1629447966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N STATE ROAD 7",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195839",
            "telephone_number": "954-486-4005",
            "fax_number": "954-497-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N STATE ROAD 7",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195800",
            "telephone_number": "954-634-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLICOTT CLINKSCALE",
        "first_name": "DAWN",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MT3549",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "MFTMFT00221521",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "MT3549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eferz LLC
• El Vignoble,LLC (Medix Pharmacy)
• Carol J Elder, LMFT
• Junie Fleurinord Elisme, MD
• Elite Phlebdna Mobile Services, LLC.
• Raynesha Andrea Ellington, M.A., BCBA, LBA
• Stacy-Ann Melissa Emmanuel
• Mattia Epps, OTD, OTR/L
• Herman Myron Epstein, M.D. F.A.C.O.G
• Paula Belen Espinoza Berrezueta, MD

• Clinical Social Worker in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.