Active NPI
Ellen Farrell, LPC
- Professional Counselor
- Thunderbolt, GA
National Provider Identifier
1144557570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC004218
- Practice address
- 415 Bonaventure Rd
Thunderbolt, GA 31404-3299 - Phone
- (912) 247-4263
- NPI assigned
- Nov 5, 2009
- Last updated
- Nov 5, 2009
- 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 | LPC004218 | GA | Primary |
Addresses
Primary practice location
415 Bonaventure Rd
Thunderbolt, GA 31404-3299
Mailing address
105 Willow Point Cir
Pooler, GA 31322-3925
Phone (912) 247-4263
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 |
|---|---|---|---|
| LPC004218 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257379200000",
"number": "1144557570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 WILLOW POINT CIR",
"city": "POOLER",
"state": "GA",
"postal_code": "313223925",
"telephone_number": "912-247-4263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 BONAVENTURE RD",
"city": "THUNDERBOLT",
"state": "GA",
"postal_code": "314043299",
"telephone_number": "912-247-4263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRELL",
"first_name": "ELLEN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-05",
"last_updated": "2009-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC004218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thunderbolt, GA
- 3223 Falligant Avenue Associates, L.P. (Thunderbolt Transitional Care and Rehabilitation)
- Adk Thunderbolt Operator, LLC (Tara at Thunderbolt Nursing & Rehab Center)
- Bainmed LLC
- Robert James Egan, LAPC
- Lorraine Soles Eufemia, NP
- Gateway Behavioral Health Services
- Gateway Behavioral Health Services (Gateway BHS - Chatham TC Now)
- Gateway Behavioral Health Services
- Gateway Behavioral Health Services
- Taylor Goldman, PT,DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.