NPIMap

Individual provider Active NPI

Savannah Ellis, LSW

  • Clinical Social Worker
  • West Chester, OH
National Provider Identifier
1811492010
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S.1500618 Issued in OH
Practice address
8904 Brookside Ave
West Chester, OH 45069-3139
Phone
(513) 644-1030
Fax
(513) 644-1025
NPI assigned
Mar 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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 S.1500618 OH Primary

Addresses

Primary practice location

8904 Brookside Ave
West Chester, OH 45069-3139

Mailing address

8904 Brookside Ave
West Chester, OH 45069-3139
Phone (513) 644-1030

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

LicenseStateTypeSpecialty
S.1500618OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Focus on Youth, Inc. 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": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1811492010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8904 BROOKSIDE AVE",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450693139",
            "telephone_number": "513-644-1030",
            "fax_number": "513-644-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8904 BROOKSIDE AVE",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450693139",
            "telephone_number": "513-644-1030",
            "fax_number": "513-644-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SAVANNAH",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1500618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.