Individual provider Active NPI

Robert Christopher Ellis, LPCC

  • Professional Counselor
  • Las Cruces, NM
National Provider Identifier
1144709379
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CTB20230533 Issued in NM
Practice address
530 N Church St
Las Cruces, NM 88001-3440
Phone
(575) 526-9878
NPI assigned
Aug 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CMH0222381 NM
Professional Counselor 101YP2500X CTB20230533 NM Primary

Addresses

Primary practice location

530 N Church St
Las Cruces, NM 88001-3440

Mailing address

530 N Church St
Las Cruces, NM 88001-3440
Phone (575) 526-9878

Other names 1

  • Robert Santiago Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CMH0222381NMMDMental Health Counselor
CTB20230533NMMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Las Cruces, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

530 N Church St
Las Cruces, NM 88001
Phone (575) 526-9878

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1144709379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N CHURCH ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013440",
            "telephone_number": "575-526-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N CHURCH ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013440",
            "telephone_number": "575-526-9878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ROBERT",
        "middle_name": "CHRISTOPHER",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CMH0222381",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CTB20230533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "SANTIAGO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.