Jason Elliott, MA, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39002433A Issued in IN

Practice address

2100 Goshen Rd
Fort Wayne, IN 46808-1493

Phone

(260) 471-3500

Fax

(260) 471-4263

NPI assigned

Aug 20, 2010

Last updated

Jan 7, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aberdeen Group LLCGroup PAC ID 5597922757, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aberdeen Group LLC

  • Psychologist
  • Fort Wayne, IN
  • NPI 1124302237
  Medicare reassignment Care Compare group NPD
• Aberdeen Group LLC

  • Psychologist
  • Fort Wayne, IN
  • NPI 1730897794
  NPD
• Bowen Health Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Wayne, IN
  • NPI 1023668183
  NPD (past)
• Bowen Health Inc

  dba Otis R Bowen Center

  • Adult Mental Health Clinic/Center
  • Warsaw, IN
  • NPI 1639172810
  NPD (past)

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1164738746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 N HARRISON ST",
            "address_2": "ATTN: ANNE LAWSON",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803163",
            "telephone_number": "574-267-7169",
            "fax_number": "574-268-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GOSHEN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468081493",
            "telephone_number": "260-471-3500",
            "fax_number": "260-471-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "JASON",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-20",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002433A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Natasha Elliott, FNP-C
• Brittany L Elliott, BT
• Chad Elliott, DO
• Charlotte Elliott, LCSW
• Gail B Elliott, PT
• Gerald Ellis
• Isaiah Ellis
• Jaya Ellis
• Jennifer Ellis, ED.S., NCSP
• Sabrina Joline Ellis, DDS

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.