Individual provider Active NPI

Ellen Ley, LCSW

  • Clinical Social Worker
  • Ashland, OR
National Provider Identifier
1710015599
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L5017SR Issued in OR
Practice address
320 E Main St
Ste 208
Ashland, OR 97520-6801
Phone
(541) 500-8655
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L5017SR OR Primary
Clinical Social Worker 1041C0700X LCS11989 CA

Addresses

Primary practice location

320 E Main St
Ste 208
Ashland, OR 97520-6801

Mailing address

PO Box 4752
Medford, OR 97501-0197
Phone (415) 500-8655

Other identifiers 1

IdentifierTypeStateIssuer
FHC03906FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20131209001355 OR Practitioner - Clinical Social Worker 9032346598 Practice locations: Ashland, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Southern California Keck School of Medicine, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

320 E Main St
Suite 208
Ashland, OR 97520-6801
Phone (541) 646-2480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS11989CAMDClinical Social Worker
L5017SRORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1710015599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4752",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010197",
            "telephone_number": "415-500-8655",
            "fax_number": "800-433-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E MAIN ST",
            "address_2": "STE 208",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975206801",
            "telephone_number": "541-500-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEY",
        "first_name": "ELLEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L5017SR",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS11989",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC03906F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

Verify at the official NPI Registry.