Racquel Ellis

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

011679 Issued in NY

Practice address

2233 Nostrand Ave
Brooklyn, NY 11210

Phone

(718) 258-1714

NPI assigned

Nov 15, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MCCD Psychiatry Services PLLCGroup PAC ID 4082049036, 206 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• MCCD Psychiatry Services PLLC

  • Psychiatry Physician
  • New York, NY
  • NPI 1033750823
  Medicare reassignment Care Compare group NPD
• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219
  Medicare reassignment NPD
• Knapp Street Psychiatry, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1043248776
  Medicare reassignment NPD
• Peace of Mind Clinical and Consulting Services Inc.

  • Mental Health Counselor
  • Jamaica, NY
  • NPI 1376263913
  NPD Authorized official
• Peace of Mind Mental Health Counseling Services P.C.

  • Mental Health Counselor
  • Jamaica, NY
  • NPI 1528740545
  NPD Authorized official
• South Bay Mental Health

  • Community/Behavioral Health Agency
  • Dorchester, MA
  • NPI 1932535333
  NPD (past)

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1043723828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8825 153RD ST APT 2P",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323752",
            "telephone_number": "347-416-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11210",
            "telephone_number": "718-258-1714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 MacDonough St",
            "address_2": "3N",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11216",
            "country_code": "US",
            "telephone_number": "347-475-1676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "RACQUEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "01482-02",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "011679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Ashley Ellis, FNP
• Linea Ellis
• Lorenzo Ellis
• Mercedes Ellis, MSCED
• Monique Lynette Ellis
• Sarah Ellis
• Toby Ellis
• Tyiesha Ellis, LMSW
• Wanda Ellis, LMSW
• Danita Ellison, FNP

• Mental Health Counselor in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.