Sherell Ellis, LPC; BCBA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC008669 Issued in GA

Practice address

2100 Central Ave Ste D1
Augusta, GA 30904-6709

Phone

(706) 843-6241

NPI assigned

Apr 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Trutherapy LPC Corp

  • Community/Behavioral Health Agency
  • Augusta, GA
  • NPI 1992224299

  Professional

  NPD

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1093169369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2932 AYLESBURY DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309090628",
            "telephone_number": "706-589-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CENTRAL AVE STE D1",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046709",
            "telephone_number": "706-843-6241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SHERELL",
        "credential": "LPC; BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008669",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Kyleen Ellis
• Jessica Ellis
• Lauren Nicole Ellis, MD
• Patricia Ellis
• Shamara Ellis
• Terry Randal Ellis, DMD
• William John Ellis, ATC
• Gregory Taylor Ellison
• William Ellisor, RPH, PHARMD
• Ahmed A. Elmarakby, DR.

• Professional Counselor in Augusta, GA
• Providers in Augusta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.