MKAYLA TAYLOR ELLSWORTH, LBSW, BS — NPI 1306674700 (Licensed & Credentialed Social Worker, School in BLOOMFIELD, NM)

CMS-1500 Box 24J / 33a • NPI

1306674700

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

1041S0200X

Licensed & Credentialed Social Worker, School

Box 32 Service Location & ZIP+4

520 N 1ST ST, BLOOMFIELD, NM, 87413-5307

✓ 9-Digit EDI 837 ZIP+4 (87413-5307)

Practice Phone & Referral Fax

(505) 634-3400

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1306674700 (MKAYLA TAYLOR ELLSWORTH, LBSW, BS) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1306674700` (NPI-1 Individual Practitioner)
Provider / Legal Name	MKAYLA TAYLOR ELLSWORTH, LBSW, BS
Plain-English Specialty	Licensed & Credentialed Social Worker, School NUCC Code: `1041S0200X` (Social Worker, School)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	520 N 1ST ST, BLOOMFIELD, NM, 87413-5307
Practice Telephone / Fax	Tel: (505) 634-3400
Administrative Mailing Address	325 N BERGIN LN, BLOOMFIELD, NM, 87413-6729
Enumeration & Last Sync	Enumerated: 2024-07-25 \| CMS Record Updated: 2024-07-25

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

520 N 1ST ST, BLOOMFIELD, NM, 87413-5307

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Plain-English Taxonomy & CMS Crosswalk (1041S0200X)

What Does Taxonomy Code 1041S0200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1041S0200X translates to:
"Licensed & Credentialed Social Worker, School"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Social Worker, School for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MKAYLA TAYLOR ELLSWORTH, LBSW, BS)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`1041S0200X` — Social Worker, School Plain English: Licensed & Credentialed Social Worker, School	State: NM \| License: `SWB-2024-0680` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MKAYLA TAYLOR ELLSWORTH, LBSW, BS (NPI #1306674700)