Diane Carol Ellis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-2855 Issued in AZ

Practice address

5527 W Marconi Ave
Glendale, AZ 85306-2402

Phone

(602) 329-7938

Fax

(602) 307-5021

NPI assigned

Apr 20, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1982091690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5527 W MARCONI AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853062402",
            "telephone_number": "602-329-7938",
            "fax_number": "602-307-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5527 W MARCONI AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853062402",
            "telephone_number": "602-329-7938",
            "fax_number": "602-307-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "DIANE",
        "middle_name": "CAROL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-2855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth J Roberts PLLC
• Elizabeth Yushuva Rpac, PLLC
• Kaela Eller, PHARMD
• Tracy Lynn Elliott, LMFT
• Angelique Ellis
• John William Ellis, D.O.
• Nicholas Daniel Ellis, PHARMD
• Renee M Ellis
• Tanya Shawn Ellis, MD
• Vonda Lanete Ellis

• Clinical Social Worker in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.