Angela Luana Ellis, LCSW
NPI 1548976202ActiveIndividual· Social Worker· Rexburg, ID
Social Worker (LCSW) in Rexburg, Idaho, licensed in ID, with an NPI issued in January 2023. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1548976202 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | No |
| NPI issued | Jan 26, 2023 |
| Last updated in NPPES | Aug 28, 2026 |
| Certified by provider | Aug 28, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | 8861855 | ID |
| Social Worker | 104100000X | LMSW-41785 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (ID) |
|---|
Education and affiliations
| Graduation year | 2013 |
|---|---|
| Medicare specialty | Clinical Social Worker |
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