Deborah S Ellis, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW01473 Issued in RI

Practice address

1130 Ten Rod Rd
Suite D-104
North Kingstown, RI 02852-4161

Phone

(401) 295-5575

Fax

(401) 295-5552

NPI assigned

Aug 12, 2006

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in RI

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Martha Dempster, Licsw, LLC

  • Community/Behavioral Health Agency
  • North Kingstown, RI
  • NPI 1073666913
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1740292390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 TEN ROD RD",
            "address_2": "SUITE D-104",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524161",
            "telephone_number": "401-258-7511",
            "fax_number": "401-295-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 TEN ROD RD",
            "address_2": "SUITE D-104",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524161",
            "telephone_number": "401-295-5575",
            "fax_number": "401-295-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "DEBORAH",
        "middle_name": "S",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH STRATEGIES",
            "identifier": "1033160",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "410115",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "21729-1",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "722607000",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Clark Dwyer, LMHC
• Linda E Eddleston, PCNS BC
• Edward a Hart DMD PC
• Maria Eugenia Eguia-Brusco, PHD
• Elizabeth M. Voso
• Andrea Franson Elmere, PMHNP
• Embodied Living Counseling, LLC
• Andrea R. Erickson, LMHC
• Arthur Edward Erskine III, LMHC
• George Michael Escobar, CDOE

• Clinical Social Worker in North Kingstown, RI
• Providers in North Kingstown, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.