Ellie Stacey Ettman, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC006011 Issued in PA

Practice address

140 W Germantown Pike Ste 160
Plymouth Meeting, PA 19462-1421

Phone

(610) 892-3800

NPI assigned

Sep 19, 2019

Last updated

Nov 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Delaware County Professional Services, Inc

  dba LifeStance

  • Psychiatry Physician
  • Media, PA
  • NPI 1952485864
  Medicare reassignment

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1023668134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W GERMANTOWN PIKE STE 160",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621421",
            "telephone_number": "610-892-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W GERMANTOWN PIKE STE 160",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621421",
            "telephone_number": "610-892-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTMAN",
        "first_name": "ELLIE",
        "middle_name": "STACEY",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-19",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC006011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joelle Essombe, LPN
• Amy Esterly, PTA
• Marc Daryl Tan Estioko, M.D.
• Anita Etheredge
• Ethos Treatment Outpatient, LLC
• Melannie Evangelista, RN
• Bernardine Evans, PT,DPT,GCS
• Callie J Evans
• Danielle E. Evans, CNA
• Debra Evans

• Professional Counselor in Plymouth Meeting, PA
• Providers in Plymouth Meeting, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.