Jodie Lynn Ellis | Milwaukee, WI • PECOS Search

Jodie Lynn Ellis

Social Worker

Behavioral Health & Social Service Providers

5000 W National Ave, Milwaukee, WI 53295-0001

(414) 384-2000 (920) 980-6947

PECOS Enrollment

Based on the most recent information from CMS, provider Jodie Lynn Ellis does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1093922270
Provider Type
Individual
Full Name
Ellis, Jodie Lynn
Title
Ms.
Credential
MSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
5/17/2007
Last Updated
7/8/2007

Contact Information

Practice Location

5000 W National Ave, Milwaukee, WI 53295-0001

(414) 389-4199

Mailing Location

2414 Main Ave, Sheboygan, WI 53083-3854

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 104100000X Primary	Description Social Worker Behavioral Health & Social Service Providers	License Unlisted Issuer Wisconsin