Timothy Elliott, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904008329 Issued in VA

Practice address

3801 Fairfax Dr
Ste 53
Arlington, VA 22203-1762

Phone

(301) 679-5785

NPI assigned

Apr 20, 2015

Last updated

Sep 5, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective Jul 1, 2019 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473033600000",
    "number": "1699162487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 FAIRFAX DR",
            "address_2": "SUITE 53",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031762",
            "telephone_number": "301-679-5785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 FAIRFAX DR",
            "address_2": "STE 53",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031762",
            "telephone_number": "301-679-5785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "TIMOTHY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-20",
        "last_updated": "2016-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15395",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50079203",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Dental
• Elite Dental
• Elite OB/GYN
• Joan Elliott
• John Jeffrey Elliott, MD
• Andy D Ellis, HS2
• Marianne Greely Ellis, PHD
• Timothy Andrew Ellsworth, PSY.D.
• Sherif Elmahdy, M.D.
• Ahmad Elmohtaseb, DDS

• Clinical Social Worker in Arlington, VA
• Providers in Arlington, 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 Sep 5, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.