ELLEN PETERSON LCSW - NPI 1760972350 - Social Worker in Ithaca, NY

Q: What is Ellen Peterson's NPI number?

The NPI number for Ellen Peterson is 1760972350. It was assigned to this individual provider in the NPPES registry on May 18, 2018.

Q: What is Ellen Peterson's specialty?

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

Q: Is Ellen Peterson enrolled in Medicare?

No. Ellen Peterson has opted out of Medicare through August 22, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Ellen Peterson was last updated on May 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

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About Ellen Peterson Lcsw NPPES

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

ELLEN PETERSON LCSW (NPI 1760972350) is an individual clinical provider in Ithaca, New York, licensed in (PR043246-1) and active in the NPI registry since May 2018. She has opted out of Medicare through August 22, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1760972350

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameELLEN PETERSONCredential: LCSW

Location Address402 N CAYUGA STIthaca, NY 14850-4291

Mailing Address402 N Cayuga StIthaca, NY 14850-4291 · (607) 793-4668

Phone(607) 793-4668

Sole ProprietorYes

Enumeration DateMay 18, 2018

✔ NPI 1760972350 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed · PR043246-1

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.

402 N CAYUGA ST, Ithaca, NY 14850

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ellen Peterson 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 August 22, 2019 through August 22, 2027.

Opt-Out Effective DateAugust 22, 2019

Opt-Out In Effect ThroughAugust 22, 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 14850 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 $54.87 – $166.88

Typical copayment $0.00 (range $13.71 – $41.72)

Most-billed visit code NA

Established Patient

$68.57 typical visit price

range $17.54 – $136.14

Typical copayment $17.14 (range $4.38 – $34.03)

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 12

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

SERENITY CARE FACILITIES LLC

Clinic/Center (Birthing)