Elizabeth Elaine Ellis, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I 06307 Issued in NM

Practice address

7950 Marne Rd
Fort Benning, GA 31905-3175

Phone

(762) 408-2610

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1750458063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7715 AURORA DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319091601",
            "telephone_number": "915-345-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 MARNE RD",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319053175",
            "telephone_number": "762-408-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ELIZABETH",
        "middle_name": "ELAINE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I 06307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Dowd
• Michelle Joanne Drumm-Williams, LPN
• John Caleb Duke, PHARMD
• Brianna Dunn, RD
• Linda Faye Eason, FNP
• Darryl Mel Ence, PHYSICAL THERAPIST
• Robert Engel, D.D.S.
• Kenneth J Erley, DMD
• Jason N Ernest, CRNA
• Christopher M Evans, DMD

• Clinical Social Worker in Fort Benning, GA
• Providers in Fort Benning, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.