Judith Ellison, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005117 Issued in MO

Practice address

3738 Chouteau Ave
Suite 200
Saint Louis, MO 63110-2546

Phone

(314) 772-8801

Fax

(314) 772-7988

NPI assigned

May 12, 2008

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

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Community Alternatives, Inc.

  • Community/Behavioral Health Agency
  • Saint Louis, MO
  • NPI 1932263423
  NPD (past)

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1861669566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3738 CHOUTEAU AVE",
            "address_2": "SUITE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102546",
            "telephone_number": "314-772-8801",
            "fax_number": "314-772-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3738 CHOUTEAU AVE",
            "address_2": "SUITE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102546",
            "telephone_number": "314-772-8801",
            "fax_number": "314-772-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "JUDITH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "005117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherry Lynne Ellis
• Sophia Ellis
• Tiffany Ellis
• William Grant Ellis, LPC
• Angela Ellison, LPTA
• Jennifer Ellner
• Andre Demarlo Ells Jr.
• Barbara A Ellzey, MD
• Aly Elmashad, MD
• Marilyn Kay Elmendorf, BSN

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.