Active NPI
Ellie Collins
- Mental Health Counselor
- Old Washington, OH
National Provider Identifier
1043924681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C.2304569-TRNE
- Practice address
- 239A Old National Rd
Old Washington, OH 43768-5000 - Phone
- (740) 489-5571
- Fax
- (740) 489-5004
- NPI assigned
- Jan 9, 2023
- 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 | C.2304569-TRNE | OH | Primary |
Addresses
Primary practice location
239A Old National Rd
Old Washington, OH 43768-5000
Mailing address
PO Box 94
Old Washington, OH 43768-0094
Phone (740) 489-5571
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 |
|---|---|---|---|
| C.2304569-TRNE | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Ohio Counseling Center, LLC. | Current | Accepting new patients | |
| Southeastern Ohio Counseling Center, LLC. | Current | Accepting new patients |
Locations
239A Old National Rd
Old Washington, OH 43768
Phone (740) 489-5571
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/southeasternohiocounseling/r4/
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Old Washington, OH
- NPI 1306459821
-
- Community/Behavioral Health Agency
- Old Washington, OH
- NPI 1679844526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673222400000",
"number": "1043924681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 94",
"city": "OLD WASHINGTON",
"state": "OH",
"postal_code": "437680094",
"telephone_number": "740-489-5571",
"fax_number": "740-489-5004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "239A OLD NATIONAL RD",
"city": "OLD WASHINGTON",
"state": "OH",
"postal_code": "437685000",
"telephone_number": "740-489-5571",
"fax_number": "740-489-5004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "ELLIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-09",
"last_updated": "2023-01-09",
"certification_date": "2023-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "C.2304569-TRNE",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Old Washington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.