Individual provider Active NPI

Veronica Agredano Ellis, BS

  • Clinical Social Worker
  • Casa Grande, AZ
National Provider Identifier
1740734458
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1115 E Florence Blvd
Casa Grande, AZ 85122-4228
Phone
(520) 252-3820
NPI assigned
Aug 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1115 E Florence Blvd
Casa Grande, AZ 85122-4228

Mailing address

PO Box 5384
1535 W Camino Seco
Oracle, AZ 85623
Phone (520) 252-3820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20260408001894 AZ Practitioner - Mental Health Counselor 0244705127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Horizon Health and Wellness, Inc.Group PAC ID 6406759711, 17 clinicians

Practice addresses (Care Compare)

980 E Mt Lemmon Rd
Oracle, AZ 85623
Phone (520) 892-9240

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Health & Wellness, Inc. Past Accepting new patients
Horizon Health and Wellness, Inc. Professional Past Accepting new patients
Horizon Health & Wellness, Inc. Past Accepting new patients
Horizon Health and Wellness, Inc. Past Accepting new patients
Horizon Health and Wellness, Inc. Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1740734458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5384",
            "address_2": "1535 W CAMINO SECO",
            "city": "ORACLE",
            "state": "AZ",
            "postal_code": "85623",
            "telephone_number": "520-252-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 E FLORENCE BLVD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224228",
            "telephone_number": "520-252-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGREDANO ELLIS",
        "first_name": "VERONICA",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

Verify at the official NPI Registry.