Tyiesha Ellis, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

100215 Issued in NY

Practice address

2901 Campus Rd
Brooklyn, NY 11210-2153

Phone

(718) 692-1929

NPI assigned

Apr 24, 2017

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 NY

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 and National Provider Directory roles.

• C H T Services Inc

  • Clinic/Center
  • Brooklyn, NY
  • NPI 1508168675
  Medicare reassignment NPD

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

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493424000000",
    "number": "1699200998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 CAMPUS RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112102153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 CAMPUS RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112102153",
            "telephone_number": "718-692-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "TYIESHA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-24",
        "last_updated": "2017-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "100215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercedes Ellis, MSCED
• Monique Lynette Ellis
• Racquel Ellis
• Sarah Ellis
• Toby Ellis
• Wanda Ellis, LMSW
• Danita Ellison, FNP
• Sydney Hunter Ellison, LMSW
• Thomasena L Ellison, MD FACOG
• Trey S Ellison

• Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2017; 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.