Active NPI
Ellen Abrams Blankenship, MS, NCC, LPC
- Professional Counselor
- Shorewood, WI
National Provider Identifier
1104405760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1172-125
- Practice address
- 4326 N Ardmore Ave
Shorewood, WI 53211-1416 - Phone
- (414) 750-0263
- NPI assigned
- Apr 2, 2021
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1172-125 | WI | Primary |
Addresses
Primary practice location
4326 N Ardmore Ave
Shorewood, WI 53211-1416
Mailing address
4326 N Ardmore Ave
Shorewood, WI 53211-1416
Phone (414) 750-0263
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1172-125 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617321600000",
"number": "1104405760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4326 N ARDMORE AVE",
"city": "SHOREWOOD",
"state": "WI",
"postal_code": "532111416",
"telephone_number": "414-750-0263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4326 N ARDMORE AVE",
"city": "SHOREWOOD",
"state": "WI",
"postal_code": "532111416",
"telephone_number": "414-750-0263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANKENSHIP",
"first_name": "ELLEN",
"middle_name": "ABRAMS",
"name_prefix": "Ms.",
"credential": "MS, NCC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-02",
"last_updated": "2021-04-02",
"certification_date": "2021-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "1172-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shorewood, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.