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

Ellis Vernon III, LCSW

Individual provider Clinical Social Worker · NPI 1700275625

Ellis Vernon III, LCSW is a Clinical Social Worker in Hawthorne, California. Graduated from University of Southern California Keck School of Medicine in 2013, 13 years ago. Practices with Los Angeles County Department of Mental Health, a 294-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
13
Trained at
University of Southern California Keck School of Medicine
Licensed in
CA
In the registry since
2015
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

2311 W El Segundo Blvd
Hawthorne, CA 90250
Phone: (323) 241-6733
Fax: (323) 756-1163
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW82566 (CA)
Clinical Social Worker Taxonomy 1041C0700X · Licence ASW59508 (CA)

Record details

NPI number1700275625
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJanuary 15, 2015
Last updated in NPPESMarch 10, 2021
Certification dateMarch 10, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice Los Angeles County Department Of Mental Health — 294 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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