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

Individual provider Clinical Social Worker · NPI 1487165932

Mr. Jesse Wren Ellis, LCSW is a Clinical Social Worker in Provo, Utah. Qualified in 2010, 16 years ago. Practices with Ihc Health Services Inc, a 3,947-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
16
Licensed in
UT
In the registry since
2017
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1157 N 300 W
Provo, UT 84604-6124
Phone: (801) 357-7525
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 7748699-3501 (UT)

Record details

NPI number1487165932
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedOctober 23, 2017
Last updated in NPPESOctober 23, 2017

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Ihc Health Services Inc — 3947 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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