Deanna Renae Ellis-Chopin, PSYCHOLOGIST

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

6361000635 Issued in MI

Practice address

1800 Pipestone Rd # 8776
Benton Harbor, MI 49022-2311

Phone

(269) 369-1753

NPI assigned

Oct 24, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other names 1

• Dr. Deanna Renae Ellis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Benton Harbor Health Center PLLC

  • Specialist
  • Benton Harbor, MI
  • NPI 1528182656

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1013090679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8776",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490238776",
            "telephone_number": "269-369-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 PIPESTONE RD # 8776",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490222311",
            "telephone_number": "269-369-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS-CHOPIN",
        "first_name": "DEANNA",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MI",
            "license": "6301010775",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6361000635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNA",
            "last_name": "ELLIS",
            "middle_name": "RENAE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gabrielle Louise Edmundson
• Eve Victoria Edwards
• Larry Wayne Edwards, BS
• David Karsten Eisenhart, M.A., BCABA
• Elite Living Services LLC
• Robyn Jean Emde, LPC
• Mariana Jacqueline Enix
• Jeannshy Erazo
• Raymond W Ervin, CPRM
• Gerald Espiritu, P.T.

• Counseling Psychologist in Benton Harbor, MI
• Providers in Benton Harbor, MI by specialty
• Counseling Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.