Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Carly M. Ellis, LICSW

Individual provider Clinical Social Worker · NPI 1205317062

Carly M. Ellis, LICSW is a Clinical Social Worker in Boston, Massachusetts. Works from 2 locations. Licensed in Massachusetts.

Licensed in
MA
In the registry since
2018
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

1 Boston Medical Ctr Pl Dept OF
Boston, MA 02118-2908
Phone: (617) 414-5245
Fax: (617) 414-5520
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 61 Medford St, Somerville, MA 02143-3421 — (617) 628-2601

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 121103 (MA)

Record details

NPI number1205317062
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedAugust 28, 2018
Last updated in NPPESDecember 15, 2023
Certification dateDecember 15, 2023

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