1. Home
  2. Directory
  3. California
  4. Palm Desert
  5. Social Worker
  6. NPI Profile

KELLY A ELLIS LCSW
NPI 1073548186
Social Worker - Clinical in Palm Desert, CA

Active since July 11, 2006Opted out of Medicare · through Jul 1, 2027
39760 BLACK MESA LN, PALM DESERT, CA 92260(760) 832-4904 Get Directions Write a Review

NPPES record last updated: August 1, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kelly A Ellis Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY A ELLIS LCSW (NPI 1073548186) is an individual clinical provider in Palm Desert, California, licensed in Colorado (CSW.0992416) and active in the NPI registry since July 2006. She has opted out of Medicare through July 1, 2027 and maintains a secondary practice location in Rancho Mirage.

NPPES Registry Identity

NPI1073548186
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKELLY A ELLISCredential: LCSW
Location Address39760 BLACK MESA LNPalm Desert, CA 92260
Mailing AddressPo Box 2805Rancho Mirage, CA 92270-2805 · (760) 832-4904
Phone(760) 832-4904
Sole ProprietorYes
Enumeration DateJuly 11, 2006
Last NPPES UpdateAugust 1, 2023
NPPES CertifiedAugust 1, 2023
✔ NPI 1073548186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in CO · CSW.0992416✔ Licensed in CA · LCS 16686
Definition
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.
39760 BLACK MESA LN, Palm Desert, CA 92260
Open in Google Maps ↗

Secondary Practice Location 1

Location 142222 Rancho Las Palmas Dr #2805, TelehealthRancho Mirage, CA 92270 · Phone (760) 832-4904

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Kelly A Ellis Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2025 through July 1, 2027.

Opt-Out Effective DateJuly 1, 2025
Opt-Out In Effect ThroughJuly 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92260 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $59.60 – $179.42
Typical copayment $0.00 (range $14.90 – $44.85)
Most-billed visit code NA
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELLY A. ELLIS
Social Worker (Clinical)
39760 BLACK MESA LN
PALM DESERT, CA 92260
Riverside County (760) 832-4904

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Ellis's NPI number?

The NPI number for Kelly Ellis is 1073548186. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is Kelly Ellis located?

Kelly Ellis practices at 39760 Black Mesa Ln, Palm Desert, CA 92260. The listed phone number is (760) 832-4904.

What is Kelly Ellis's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kelly Ellis enrolled in Medicare?

No. Kelly Ellis has opted out of Medicare through July 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Kelly Ellis was last updated on August 1, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.