MR. CHARLES ELLIS (LCSW-C) – Mental Health Counselor, NPI 1215017009
Mental Health Counselor
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
548 CLINICAL SOCIAL WORKER in NV
Provider Addresses for MR. CHARLES ELLIS (LCSW-C)
2725 S Jones Blvd Ste 101
Las Vegas, NV 891465605
Phone: (725) 214-1378
Fax: (702) 384-2239
Type: Location
1501 Division St
Baltimore, MD 212173121
Phone: (410) 383-8300
Fax: (410) 383-3160
Type: Location
1501 DIVISION ST
BALTIMORE, MD 212173121
Phone: (410) 383-8300
Fax: (410) 383-3160
Type: Mailing
4164 BROCKTON AVE
RIVERSIDE, CA 925013400
Phone: (951) 683-5193
Type: Mailing
5130, South Pecos Road, Clark County, Nevada, 89120, United States
SUITE 2B
LAS VEGAS, NV 89120
Phone: (702) 560-5973
Fax: (888) 753-3302
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-12-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160118000247 | I | Clinical Social Worker | NV | TBD |
| I20211220001858 | I | Clinical Social Worker | MD | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 89146)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | NV | |
| Nurse Practitioner | NV | |
| Psychiatry, Pain Management | OK |
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