Active NPI
Jenna Lee Ellis, MA, LMHC
- Mental Health Counselor
- Lakeville, MA
National Provider Identifier
1194095406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 9907
- Practice address
- 109 Rhode Island Rd Ste D
Lakeville, MA 02347-1370 - Phone
- (774) 955-0494
- Fax
- (774) 250-3210
- NPI assigned
- Jan 3, 2012
- 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 | 9907 | MA | Primary |
Addresses
Primary practice location
109 Rhode Island Rd Ste D
Lakeville, MA 02347-1370
Mailing address
109 Rhode Island Rd Ste D
Lakeville, MA 02347-1370
Phone (774) 955-0494
Other names 1
- Jenna Lee Claes
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9907 | MA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spill the Tea Psychotherapy LLC | Mental Health | Current | Accepting new patients |
Locations
109 Rhode Island Rd
Ste D
Lakeville, MA 02347
Phone (774) 955-0494
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": "1325548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708992000000",
"number": "1194095406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 RHODE ISLAND RD STE D",
"city": "LAKEVILLE",
"state": "MA",
"postal_code": "023471370",
"telephone_number": "774-955-0494",
"fax_number": "774-250-3210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 RHODE ISLAND RD STE D",
"city": "LAKEVILLE",
"state": "MA",
"postal_code": "023471370",
"telephone_number": "774-955-0494",
"fax_number": "774-250-3210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "JENNA",
"middle_name": "LEE",
"credential": "MA, LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-03",
"last_updated": "2024-02-27",
"certification_date": "2024-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "9907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNA",
"last_name": "CLAES",
"middle_name": "LEE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lakeville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.