Active NPI
Jessica Ellard, LMSW
- Clinical Social Worker
- Southfield, MI
National Provider Identifier
1710409156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801100883
- Practice address
- 30503 Greenfield Rd
Southfield, MI 48076-1594 - Phone
- (248) 691-4744
- Fax
- (248) 691-4745
- NPI assigned
- Jul 7, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801100883 | MI | Primary |
Addresses
Primary practice location
30503 Greenfield Rd
Southfield, MI 48076-1594
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Other practice location 1
279 Summit Dr
Waterford, MI 48328-3364
Phone (248) 871-4181
Other practice location 2
1270 Doris Rd
Auburn Hills, MI 48326-2617
Phone (248) 276-8000
Other names 1
- Jessica Rheaume
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801100883 | MI | MD | Clinical Social Worker |
Organizations & group practices 1
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.
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- Royal Oak, MI
- NPI 1578072906
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648684800000",
"number": "1710409156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30503 GREENFIELD RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480761594",
"telephone_number": "248-691-4744",
"fax_number": "248-691-4745"
}
],
"practiceLocations": [
{
"address_1": "279 Summit Dr",
"address_purpose": "LOCATION",
"city": "Waterford",
"state": "MI",
"postal_code": "483283364",
"country_code": "US",
"telephone_number": "248-871-4181",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1270 Doris Rd",
"address_purpose": "LOCATION",
"city": "Auburn Hills",
"state": "MI",
"postal_code": "483262617",
"country_code": "US",
"telephone_number": "248-276-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELLARD",
"first_name": "JESSICA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-07",
"last_updated": "2022-03-31",
"certification_date": "2022-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801100883",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "RHEAUME",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.