T. Nicole Ellis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904008384 Issued in VA

Practice address

780 Pilot House Dr Ste 100a
Newport News, VA 23606-4411

Phone

(757) 593-1840

NPI assigned

Nov 1, 2013

Last updated

Jan 28, 2022By 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

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Salubrious Therapy Solutions LLC

  • Clinical Social Worker
  • Newport News, VA
  • NPI 1952996373
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1649609546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 OLDE BUCKINGHAM RD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236691916",
            "telephone_number": "757-593-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 PILOT HOUSE DR STE 100A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064411",
            "telephone_number": "757-593-1840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1819 Olde Buckingham Rd",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236691916",
            "country_code": "US",
            "telephone_number": "757-593-3953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "T. NICOLE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-01",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Baylor Ellis, DO
• Elizabeth Hope Ellis, PA
• Kimberly Ellis
• Lynn B Ellis, NP
• R Benjamin Ellis, DDS
• Veronica Y Ellis
• Zainab Asmau Elmohammed, MLS(ASCP)
• Amr Aly Elsaadat, M.D.
• Embassy Newport News LLC (Regent of Newport News)
• Emed Inc (I&O Medical Centers)

• Clinical Social Worker in Newport News, VA
• Providers in Newport News, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.