Mazie Ellis, LCSWA in Fayetteville, NC - Social Worker

Mazie Ellis, LCSWA is a Social Worker - Clinical based in Fayetteville, North Carolina. Mazie Ellis is licensed to practice in North Carolina (license number P018169) and her current practice location is 3605 Camson Rd, Fayetteville, North Carolina. She can be reached at her office (for appointments etc.) via phone at (910) 391-4520.

NPI number for Mazie Ellis is 1003532052 and her current mailing address is 3605 Camson Rd, Fayetteville, North Carolina. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1003532052.

Contact Information

	Mazie Ellis, LCSWA
	3605 Camson Rd, Fayetteville, NC 28306-3743
	(910) 391-4520
	Not Available

Healthcare Provider's Profile

Full Name	Mazie Ellis
Gender	Female
Speciality	Social Worker - Clinical
Location	3605 Camson Rd, Fayetteville, North Carolina
Accepts Medicare Assignments	Does not participate in Medicare Program. She may not accept medicare assignment.

NPI Data:

NPI Number: 1003532052
Provider Enumeration Date: 10/12/2022
Last Update Date: 10/30/2023

Medical Identifiers

Medical identifiers for Mazie Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003532052	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	LCAS-28501 (North Carolina)	Secondary
1041C0700X	Social Worker - Clinical	P018169 (North Carolina)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mazie Ellis is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mazie Ellis, LCSWA 3605 Camson Rd, Fayetteville, NC 28306-3743 Ph: (910) 391-4520	Mazie Ellis, LCSWA 3605 Camson Rd, Fayetteville, NC 28306-3743 Ph: (910) 391-4520

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Mazie Ellis, LCSWA - Counselor in Fayetteville, NC