National Provider Identifier Database

KELLY A ELLIS, LCSW – NPI #1073548186
Clinical

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.


Contact Information

KELLY A ELLIS, LCSW
39760 BLACK MESA LN
PALM DESERT, CA92260
Phone: 760-832-4904
Fax:
Website:
Specialty Taxonomy Code
* Clinical 1041C0700X

* Indicates primary specialty

NPI Profile & details for KELLY A ELLIS

NPI Number 1073548186
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 07/11/2006
Last updated 08/01/2023 - About 3 years ago
Sole proprietor1 Yes
Identifiers
  • CA License #: LCS 16686
  • CO License #: CSW.0992416
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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