Joey Wayne Ellis, MA, LPC

Individual provider Active NPI Mental Health Counselor · Kempner, TX

NPI 1003353772 · NPPES record last updated Jan 19, 2017

Key facts

NPI
1003353772
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
73744 (TX)
Practice address
2688 Snow Rd
Kempner, TX 76539-6838
Phone
(254) 415-5270
NPI assigned
Jan 19, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
73744TXMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 73744 TX Yes

Addresses

Primary practice location

2688 Snow Rd
Kempner, TX 76539-6838

Mailing address

2688 Snow Rd
Kempner, TX 76539-6838
Phone (254) 415-5270

Other providers in Kempner, TX

All providers in Kempner, TX · Mental Health Counselor in Texas

Sources for this page

Verify at the official NPI Registry.