Active NPI
Anne-Michelle Ellis
- Clinical Social Worker
- Riverside, CA
National Provider Identifier
1730548249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 2743 Orange St
Riverside, CA 92501-2503 - Phone
- (915) 788-9515
- NPI assigned
- Feb 12, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | ASW85397 | CA | |
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
2743 Orange St
Riverside, CA 92501-2503
Mailing address
2743 Orange St
Riverside, CA 92501-2503
Phone (915) 788-9515
Other practice location 1
4750 Palm Ave
Riverside, CA 92501-4012
Phone (951) 686-0021
Other practice location 2
2452 Wilshire St
Riverside, CA 92501-2144
Phone (951) 682-6631
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW85397 | CA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Whiteside Manor, Inc. | Past | Accepting new patients |
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.
-
- Substance Abuse Rehabilitation Facility
- Riverside, CA
- NPI 1376081323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1730548249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2743 ORANGE ST",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925012503",
"telephone_number": "915-788-9515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2743 ORANGE ST",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925012503",
"telephone_number": "915-788-9515"
}
],
"practiceLocations": [
{
"address_1": "4750 Palm Ave",
"address_purpose": "LOCATION",
"city": "Riverside",
"state": "CA",
"postal_code": "925014012",
"country_code": "US",
"telephone_number": "951-686-0021",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2452 Wilshire St",
"address_purpose": "LOCATION",
"city": "Riverside",
"state": "CA",
"postal_code": "925012144",
"country_code": "US",
"telephone_number": "951-682-6631",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELLIS",
"first_name": "ANNE-MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-12",
"last_updated": "2022-06-14",
"certification_date": "2022-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "ASW85397",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.