Ella Idil Indra, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00008708 Issued in WA

Practice address

720 N 35TH St
Seattle, WA 98103-8816

Phone

(206) 351-3831

NPI assigned

May 11, 2013

Last updated

May 11, 2013By the provider in NPPES

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

Other identifiers 1

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": "1368230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368230400000",
    "number": "1639515117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8302 26TH AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981174447",
            "telephone_number": "206-351-3831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N 35TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038816",
            "telephone_number": "206-351-3831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDRA",
        "first_name": "ELLA",
        "middle_name": "IDIL",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-11",
        "last_updated": "2013-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00008708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE",
            "identifier": "LW00008708",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Independence Rehab
• Indigenous Counseling Services PLLC
• Indigenous Living
• Indigo Mental Health PLLC (Indigo Mental Health)
• Amy Ly Indorf, PHARMD
• Samuelle Genevievre Inevil, MSN, APRN, FNP-BC
• Rae Infante Lopez, MD
• Infinitely Well Holistic Wellness PLLC (Alderson & Associates PLLC)
• Bailey Ingalls, MD
• David Ingalls, R.D.

• Clinical Social Worker in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2013; 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.