Dr Kathleen Ellis, PHD, LADC, LPC in New London, CT - Medicare Clinical Social Worker Provider

Dr Kathleen Ellis, PHD, LADC, LPC is a medicare enrolled "Counselor - Addiction (substance Use Disorder)" provider in New London, Connecticut. She graduated from healthcare school in 2011 and has 15 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Northeast Medical Group Inc, Northeast Medical Group Inc and her current practice location is 365 Montauk Ave, New London, Connecticut. You can reach out to her office (for appointments etc.) via phone at (860) 271-4271.

Dr Kathleen Ellis is licensed to practice in Connecticut (license number 000903) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1679902316.

Contact Information

	Dr Kathleen Ellis, PHD, LADC, LPC
	365 Montauk Ave, New London, CT 06320-4700
	(860) 271-4271
	(860) 444-5107

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Kathleen Ellis
Gender	Female
Speciality	Clinical Social Worker
Experience	15 Years
Location	365 Montauk Ave, New London, Connecticut
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Kathleen Ellis graduated from medical school in 2011

NPI Data:

NPI Number: 1679902316
Provider Enumeration Date: 11/04/2013
Last Update Date: 09/10/2025

Medicare PECOS Information:

PECOS PAC ID: 9739309758
Enrollment ID: I20140925000833

Medical Identifiers

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

Identifier	Type	State	Issuer
1679902316	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	000903 (Connecticut)	Primary
101YP2500X	Counselor - Professional	002541 (Connecticut)	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Northeast Medical Group Inc	1254233836	1287
Northeast Medical Group Inc	1254233836	1287

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kathleen Ellis allows following entities to bill medicare on her behalf.

Entity Name	Northeast Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043278351 PECOS PAC ID: 1254233836 Enrollment ID: O20040123000522

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. Dr Kathleen Ellis is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Kathleen Ellis, PHD, LADC, LPC 365 Montauk Ave, New London, CT 06320-4700 Ph: (860) 271-4271	Dr Kathleen Ellis, PHD, LADC, LPC 365 Montauk Ave, New London, CT 06320-4700 Ph: (860) 271-4271

Reviews and Comments

Counselor in New London, CT

Nichole Burns, Counselor Medicare: Not Enrolled in Medicare Practice Location: 21 Montauk Avene, New London, CT 06320 Phone: 860-271-4715 Fax: 860-271-4797
Theresa M. Bonanomi, Counselor Medicare: Not Enrolled in Medicare Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 860-444-5141
Stephanie Bacon, Counselor Medicare: Not Enrolled in Medicare Practice Location: Po Box 120, New London, CT 06320 Phone: 860-437-4550
Bethany Gallant, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 21 Montauk Ave, New London, CT 06320 Phone: 860-443-0530 Fax: 860-443-0536
Lindsay Warner, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 7 Vauxhall St, New London, CT 06320 Phone: 860-437-4550 Fax: 860-661-4262
Marie Salvemini, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 Shaws Cv, New London, CT 06320 Phone: 860-447-8304 Fax: 860-443-8720
Katherine Cichon, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 State St, Suite 307, New London, CT 06320 Phone: 860-941-9380

Dr Kathleen Ellis, PHD, LADC, LPC - Medicare Counselor in New London, CT