Active NPI
Elysia Oudemans-Tilley, MSW
- Clinical Social Worker
- Ellicott City, MD
National Provider Identifier
1740932607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10299
- Practice address
- 4702 Woodland Road
Ellicott City, MD 21042-6331 - Phone
- (240) 350-0026
- NPI assigned
- Jan 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904015085 | VA | |
| Clinical Social Worker | 1041C0700X | LC2000002110 | DC | |
| Clinical Social Worker | 1041C0700X | 10299 | MD | Primary |
Addresses
Primary practice location
4702 Woodland Road
Ellicott City, MD 21042-6331
Mailing address
PO Box 6111
Ellicott City, MD 21042
Phone (240) 350-0026
Other names 1
- Elysia Oudemans
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 |
|---|---|---|---|
| LC2000002110 | DC | MD | Clinical Social Worker |
| 10299 | MD | MD | Clinical Social Worker |
| 0904015085 | VA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Barker Adoption Foundation | Clinical | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688947200000",
"number": "1740932607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6111",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "21042",
"telephone_number": "240-350-0026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4702 WOODLAND ROAD",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210426331",
"telephone_number": "240-350-0026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUDEMANS-TILLEY",
"first_name": "ELYSIA",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-21",
"last_updated": "2023-07-10",
"certification_date": "2023-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904015085",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC2000002110",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "10299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELYSIA",
"last_name": "OUDEMANS",
"credential": "MSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.