MRS. MICHELLE ELLSWORTH LCSW
NPI 1700245164
Social Worker - Clinical in Roseburg, OR

Q: What is Michelle Ellsworth's NPI number?

The NPI number for Michelle Ellsworth is 1700245164. It was assigned to this individual provider in the NPPES registry on February 14, 2016.

Q: What is Michelle Ellsworth's specialty?

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

Active since February 14, 2016PECOS EnrolledAccepts Medicare Assignment

621 W MADRONE ST, ROSEBURG, OR 97470(541) 492-0158 Get Directions Write a Review

NPPES record last updated: November 6, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 6, 2018, Feb 14, 2016 (2 updates tracked since 2016).

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About Mrs. Michelle Ellsworth Lcsw NPPES

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

MRS. MICHELLE ELLSWORTH LCSW (NPI 1700245164) is an individual clinical provider in Roseburg, Oregon and active in the NPI registry since February 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Kingsford, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1700245164

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMRS. MICHELLE ELLSWORTHCredential: LCSW

Location Address621 W MADRONE STRoseburg, OR 97470-3090

Mailing Address621 W Madrone StRoseburg, OR 97470-3090 · (541) 492-0158

Phone(541) 492-0158

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateFebruary 14, 2016

Last NPPES UpdateNovember 6, 20182 updates tracked since enumeration

✔ NPI 1700245164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

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.

Also ListedSocial WorkerTaxonomy 104100000X

621 W MADRONE ST, Roseburg, OR 97470

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Secondary Practice Location 1

Location 1930 Olympic StKingsford, MI 49802-1229 · Phone (906) 221-7837

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Michelle Ellsworth Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2769728930

PECOS Enrollment IDI20190108003968

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97470 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 $54.96 – $166.64

Typical copayment $0.00 (range $13.74 – $41.66)

Most-billed visit code NA

Established Patient

$68.64 typical visit price

range $17.68 – $136.19

Typical copayment $17.16 (range $4.42 – $34.04)

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.

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Other Providers at the Same Location NPPES 20

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

WILLIAM F SHOBE JR. LMFT

Marriage & Family Therapist