Active NPI
Kelci L Ellis, LPC
- Mental Health Counselor
- Lewisville, TX
National Provider Identifier
1104684075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 83810
- Practice address
- 1301 Justin Rd
Suite 201
Lewisville, TX 75077 - Phone
- (832) 387-5503
- NPI assigned
- Mar 6, 2024
- Sex
- Female
- Sole proprietor
- No
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 | 83810 | TX | Primary |
Addresses
Primary practice location
1301 Justin Rd
Suite 201
Lewisville, TX 75077
Mailing address
5900 Balcones Dr. Ste 100
13252
Austin, TX 78731
Phone (832) 387-5503
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 |
|---|---|---|---|
| 83810 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709683200000",
"number": "1104684075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 BALCONES DR. STE 100",
"address_2": "13252",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78731",
"telephone_number": "832-387-5503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 JUSTIN RD",
"address_2": "SUITE 201",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "75077",
"telephone_number": "832-387-5503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "KELCI",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-06",
"last_updated": "2024-03-06",
"certification_date": "2024-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "83810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.