Active NPI
Gail Ellerbrake
- Mental Health Counselor
- Montgomery, AL
National Provider Identifier
1013169416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1516
- Practice address
- 4455 Narrow Lane Rd
Montgomery, AL 36116-2953 - Phone
- (334) 288-8890
- Fax
- (334) 288-9322
- NPI assigned
- Oct 16, 2008
- Last updated
- Oct 16, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1516 | AL | Primary |
Addresses
Primary practice location
4455 Narrow Lane Rd
Montgomery, AL 36116-2953
Mailing address
4455 Narrow Lane Rd
Montgomery, AL 36116-2953
Phone (334) 288-8890
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1516 | AL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Social Services | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Montgomery, AL
- NPI 1396902375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224115200000",
"number": "1013169416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4455 NARROW LANE RD",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361162953",
"telephone_number": "334-288-8890",
"fax_number": "334-288-9322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4455 NARROW LANE RD",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361162953",
"telephone_number": "334-288-8890",
"fax_number": "334-288-9322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLERBRAKE",
"first_name": "GAIL",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-16",
"last_updated": "2008-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AL",
"license": "1516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.