Jill Diane Ellinwood, MA, LCSW, LPC is a
Social Worker - Clinical based in Baraboo, Wisconsin. Jill Diane Ellinwood is licensed to practice in Wisconsin (license number 1197-123) and her current practice location is
505 Broadway St, Baraboo, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(608) 355-4214.
NPI number for Jill Diane Ellinwood is 1275666935 and her current mailing address is S5789 S Shore Rd, Baraboo, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1275666935.
Healthcare Provider's Profile
Full Name | Jill Diane Ellinwood |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 505 Broadway St, Baraboo, Wisconsin |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1275666935
- Provider Enumeration Date: 03/13/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Jill Diane Ellinwood such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1275666935 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 647-125 (Wisconsin) | Primary |
1041C0700X | Social Worker - Clinical | 1197-123 (Wisconsin) | 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. Jill Diane Ellinwood 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 |
Jill Diane Ellinwood, MA, LCSW, LPC S5789 S Shore Rd, Baraboo, WI 53913-9235 Ph: (608) 356-7039 | Jill Diane Ellinwood, MA, LCSW, LPC 505 Broadway St, Baraboo, WI 53913-2183 Ph: (608) 355-4214 |
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