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ELLIS VERNON III LCSW
NPI 1700275625
Social Worker - Clinical in Hawthorne, CA

Active since January 15, 2015PECOS EnrolledAccepts Medicare Assignment
2311 W. EL SEGUNDO BLVD, HAWTHORNE, CA 90250(323) 241-6733(323) 756-1163 Get Directions Write a Review

NPPES record last updated: March 10, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Ellis Vernon Iii Lcsw NPPES

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

ELLIS VERNON III LCSW (NPI 1700275625) is an individual clinical provider in Hawthorne, California, licensed in California (LCSW82566) and active in the NPI registry since January 2015. He is enrolled in Medicare PECOS and is a graduate of University Of Southern California Keck School Of Medicine (2013).

NPPES Registry Identity

NPI1700275625
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameELLIS VERNON IIICredential: LCSW
Location Address2311 W. EL SEGUNDO BLVDHawthorne, CA 90250
Mailing Address2311 W. El Segundo BlvdHawthorne, CA 90250 · (310) 756-3638
Phone(323) 241-6733
Fax(323) 756-1163
Sole ProprietorNo
Medical School CMSUniversity Of Southern California Keck School Of MedicineGraduated 2013
Enumeration DateJanuary 15, 2015
Last NPPES UpdateMarch 10, 2021
NPPES CertifiedMarch 10, 2021
✔ NPI 1700275625 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 CA · LCSW82566✔ Licensed in CA · ASW59508
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.
2311 W. EL SEGUNDO BLVD, Hawthorne, CA 90250
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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

Ellis Vernon Iii 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 ID5193070456
PECOS Enrollment IDI20180611001150
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 90250 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 $62.96 – $187.60
Typical copayment $0.00 (range $15.74 – $46.90)
Most-billed visit code NA
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
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.

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 Ellis Vernon's NPI number?

The NPI number for Ellis Vernon is 1700275625. It was assigned to this individual provider in the NPPES registry on January 15, 2015.

Where is Ellis Vernon located?

Ellis Vernon practices at 2311 W. El Segundo Blvd, Hawthorne, CA 90250. The listed phone number is (323) 241-6733.

What is Ellis Vernon's specialty?

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

Is Ellis Vernon enrolled in Medicare?

Yes. Ellis Vernon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Ellis Vernon was last updated on March 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.