Christine Ellis, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH13237 Issued in FL

Practice address

4300 Marsh Landing Blvd Ste 204
Jacksonville Beach, FL 32250-1420

Phone

(904) 515-2050

NPI assigned

Jun 3, 2015

Last updated

Feb 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Theralogy, LLC

  • Professional Counselor
  • Jacksonville Beach, FL
  • NPI 1154918209
  NPD Authorized official
• The LJD Jewish Family & Community Services, Inc

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1538255088

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1205216314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 ATLANTIC BLVD STE 161",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322333313",
            "telephone_number": "904-515-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARSH LANDING BLVD STE 204",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322501420",
            "telephone_number": "904-515-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CHRISTINE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA",
            "identifier": "MH13237",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Maxine Eckensberger, LMT
• Bridget Colleen Edkin, D.C.
• Samantha Ellen Eisen-Seyda, M.S.,CCC/SLP
• Skylar Elizabeth Elder
• Elite Endurance Physio LLC
• Lee Brandon Epstein, MD
• Camy Erlandson, DPT
• Alisha Evans, LMT
• Natasha Evans
• Rachael C Evans, DO

• Mental Health Counselor in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.