Active NPI
Emilie Ann Ellenberg, LMHC
- Mental Health Counselor
- New Port Richey, FL
National Provider Identifier
1205221272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH13313
- Practice address
- 7747 Mitchell Blvd Ste B
New Port Richey, FL 34655-4725 - Phone
- (813) 403-8445
- Fax
- (888) 878-0546
- NPI assigned
- Apr 6, 2015
- 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 | MH13313 | FL | Primary |
Addresses
Primary practice location
7747 Mitchell Blvd Ste B
New Port Richey, FL 34655-4725
Mailing address
7747 Mitchell Blvd Ste B
New Port Richey, FL 34655-4725
Phone (813) 403-8445
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MH13313 | Other | FL | STATE OF FLORIDA - DEPT OF HEALTH |
| 014668600 | Medicaid | FL | |
| 5796 | Other | FL | FLORIDA CERTIFICATION BOARD - CAP - ADDICTION PROFRESSIONAL |
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 |
|---|---|---|---|
| MH13313 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566950400000",
"number": "1205221272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7747 MITCHELL BLVD STE B",
"city": "NEW PORT RICHEY",
"state": "FL",
"postal_code": "346554725",
"telephone_number": "813-403-8445",
"fax_number": "888-878-0546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7747 MITCHELL BLVD STE B",
"city": "NEW PORT RICHEY",
"state": "FL",
"postal_code": "346554725",
"telephone_number": "813-403-8445",
"fax_number": "888-878-0546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLENBERG",
"first_name": "EMILIE",
"middle_name": "ANN",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-06",
"last_updated": "2019-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH13313",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF FLORIDA - DEPT OF HEALTH",
"identifier": "MH13313",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "014668600",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA CERTIFICATION BOARD - CAP - ADDICTION PROFRESSIONAL",
"identifier": "5796",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Port Richey, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.