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TIM ELLIS LCSW NPI 1811949142


NPI Information

NPI: 1811949142
Provider Name: TIM ELLIS, LCSW
Classification: Social Worker - 1041C0700X
Entity Type: Individual

Specialization: Clinical

Address:
3651 SHEPHERDSVILLE RD
ELIZABETHTOWN, KY
ZIP 42701
Phone: (270) 378-0230
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Tim Ellis, LCSW is a clinical social worker in Elizabethtown, KY. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. Tim Ellis, LCSW NPI is 1811949142. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3651 SHEPHERDSVILLE RD
ELIZABETHTOWN, KY
ZIP 42701-511
Phone: (270) 378-0230

The enumeration date for this NPI number is 5/16/2006 and was last updated on 9/9/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinical1284KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10500907MEDICARE PINKENTUCKY
20500027MEDICARE PINKENTUCKY
3P20821MEDICARE UPINKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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