Individual provider Active NPI

Ellen T. Dean, LCSW

  • Clinical Social Worker
  • Marietta, GA
National Provider Identifier
1891711735
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005021 Issued in GA
Practice address
261 Pioneer TRL
Marietta, GA 30068-3470
Phone
(646) 709-8540
NPI assigned
Jul 14, 2006
Last updated
Jun 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 076443-1 NY
Clinical Social Worker 1041C0700X CSW005021 GA Primary

Addresses

Primary practice location

261 Pioneer TRL
Marietta, GA 30068-3470

Mailing address

261 Pioneer TRL
Marietta, GA 30068-3470
Phone (646) 709-8540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20230725001301 GA Practitioner - Clinical Social Worker 7618039298 Practice locations: Marietta, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

261 Pioneer TRL
Marietta, GA 30068-3470
Phone (646) 709-8540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW005021GAMDClinical Social Worker
076443-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities Neighborhood Services, Inc. Past Accepting new patients
Catholic Charities Neigborhood Services Clinical Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1891711735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 PIONEER TRL",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300683470",
            "telephone_number": "646-709-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 PIONEER TRL",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300683470",
            "telephone_number": "646-709-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "ELLEN",
        "middle_name": "T.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076443-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.