Andrea Ellis

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC12363 Issued in ME

Practice address

14 Maine St # 54
Brunswick, ME 04011-2049

Phone

(800) 434-3000

NPI assigned

Jan 21, 2010

Last updated

Jun 13, 2011By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in ME

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sweetser

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saco, ME
  • NPI 1538122445
  Medicare reassignment NPD

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307923200000",
    "number": "1861723462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MAINE ST # 54",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112049",
            "telephone_number": "800-434-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MAINE ST # 54",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112049",
            "telephone_number": "800-434-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-21",
        "last_updated": "2011-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC12363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen W. Johnson, LCSW, LLC
• Tiffany Eisenhauer, PA-C
• Betsy Elder, LCPC-C
• Eldercare at Parkview
• Thomas Francis Elie, LCSW
• Rebecca Sue Ellis
• Frederick James Elsaesser, D.D.S.
• Jeffrey Dean Emde, P.T.
• Christine Emmanuel, DO
• David L Enright, M.D.

• Clinical Social Worker in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.