Ella M Jolly, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

072235 Issued in NY

Practice address

125 E 84TH St
Suite 2
New York, NY 10028-0902

Phone

(212) 633-7100

Fax

(212) 633-7100

NPI assigned

Mar 7, 2007

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2018 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1780714600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W 11TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118607",
            "telephone_number": "212-627-8144",
            "fax_number": "212-633-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E 84TH ST",
            "address_2": "SUITE 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280902",
            "telephone_number": "212-633-7100",
            "fax_number": "212-633-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "ELLA",
        "middle_name": "M",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "072235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P840321",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deirdre Shavon Jolivette
• Jonathan Jolivette, M.S., CCC-SLP
• Hannah Jolley
• Lynnsue Kay Jolley, LCSW
• Anu Jolly, D.D.S.
• Kimberly Jolly, PT
• Aimee Jolson, LMT
• Olivia M Joly, MD
• Jon B. Turk, M.D., P.C.
• Jon R Snyder M D P C

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.