Charlotte Elliott, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

34004693A Issued in IN

Practice address

6334 Constitution Dr
Fort Wayne, IN 46804-1518

Phone

(260) 209-1209

Fax

(260) 782-3215

NPI assigned

Dec 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Dunn Associates PC

  • Mental Health Counselor
  • Fort Wayne, IN
  • NPI 1740362391
  NPD (past)
• Elevation Enterprises, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1538932728
  NPD (past)
• Parkview Hospital, Inc.

  • Trauma Surgery Physician
  • Fort Wayne, IN
  • NPI 1669576997
  NPD (past)

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1073672937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6334 CONSTITUTION DR STE 23",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041518",
            "telephone_number": "260-209-1209",
            "fax_number": "260-782-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6334 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041518",
            "telephone_number": "260-209-1209",
            "fax_number": "260-782-3215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1910 Saint Joe Center Rd",
            "address_2": "suite 23",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468255000",
            "country_code": "US",
            "telephone_number": "260-484-5599",
            "fax_number": "260-484-5664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "CHARLOTTE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-07",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "34004693A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200026750A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Penn Ellinwood, DDS
• Alicia A Elliott, CNS
• Ann Natasha Elliott, FNP-C
• Brittany L Elliott, BT
• Chad Elliott, DO
• Gail B Elliott, PT
• Jason Elliott, MA, LMHC
• Gerald Ellis
• Isaiah Ellis
• Jaya Ellis

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.