Individual ProviderEllen LeySocial WorkerBehavioral Health & Social Service ProvidersPractice Address320 E Main St, Ste 208, Ashland, OR 97520-6801(541) 500-8655(415) 500-8655PECOS EnrollmentBased on the most recent information from CMS, provider Ellen Ley is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1710015599Provider TypeIndividualFull NameLey, EllenCredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date3/1/2007Last Updated6/2/2020Contact InformationPractice LocationPractice Address320 E Main St, Ste 208, Ashland, OR 97520-6801Phone(541) 500-8655FaxUnlisted FaxMailing LocationMailing AddressPO Box 4752, Medford, OR 97501-0197Phone(415) 500-8655Fax(800) 433-1396Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseL5017SROregonCode1041C0700XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseLCS11989CaliforniaProvider IdentifiersIDDescriptionIssuerIDFHC03906FDescriptionMedicaidIssuerUnlistedCalifornia