Active NPI
Ryan Elliott, LCSW
- Clinical Social Worker
- Baraboo, WI
National Provider Identifier
1730827833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 9604123
- Practice address
- 1212 8TH St Ste 3
Baraboo, WI 53913-1875 - Phone
- (608) 448-2497
- NPI assigned
- May 27, 2022
- Last updated
- May 27, 2022
- Sex
- Male
- 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 | 9604123 | WI | Primary |
Addresses
Primary practice location
1212 8TH St Ste 3
Baraboo, WI 53913-1875
Mailing address
1217 Debra LN
Madison, WI 53704-1416
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 |
|---|---|---|---|
| 9604123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seasons Counseling, LLC | Clinical | Current | Accepting new patients |
Locations
1212 8th St
Ste 3
Baraboo, WI 53913
Phone (608) 448-2497
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653609600000",
"number": "1730827833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1217 DEBRA LN",
"city": "MADISON",
"state": "WI",
"postal_code": "537041416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 8TH ST STE 3",
"city": "BARABOO",
"state": "WI",
"postal_code": "539131875",
"telephone_number": "608-448-2497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "RYAN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-27",
"last_updated": "2022-05-27",
"certification_date": "2022-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "9604123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baraboo, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.