Individual provider Active NPI

Alessandra Ellis-Lodmell, LCSW

  • Clinical Social Worker
  • Saint Marys, GA
National Provider Identifier
1932949443
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW009134 Issued in GA
Practice address
121 Tidal Marsh Way
Saint Marys, GA 31558-5809
Phone
(912) 467-9538
NPI assigned
May 31, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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 CSW009134 GA Primary

Addresses

Primary practice location

121 Tidal Marsh Way
Saint Marys, GA 31558-5809

Mailing address

121 Tidal Marsh Way
Saint Marys, GA 31558-5809
Phone (912) 467-9538

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
I20241114004437 GA Practitioner - Clinical Social Worker 4789118597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

121 Tidal Marsh Way
Saint Marys, GA 31558-5809
Phone (912) 216-0881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW009134GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Redesign Your Life Counseling LLC Clinical CurrentSince Sep 1, 2024 Accepting new patients

Locations

130 N Gross Rd
Ste 205
Kingsland, GA 31548
Phone (912) 223-6955

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": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1932949443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 TIDAL MARSH WAY",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315585809",
            "telephone_number": "912-467-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 TIDAL MARSH WAY",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315585809",
            "telephone_number": "912-467-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS-LODMELL",
        "first_name": "ALESSANDRA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-31",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW009134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, GA

Sources for this page

Verify at the official NPI Registry.