Jacob Michael Elliott, M.S., NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

235 Dunbar Cave Rd
Clarksville, TN 37043-8828

Phone

(931) 249-2143

NPI assigned

Jul 31, 2021

Last updated

Nov 9, 2023By 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 TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Pathfinder Counseling Group LLC

  • Mental Health Counselor
  • Clarksville, TN
  • NPI 1184477366
  Medicare reassignment NPD
• Sunrise Counseling Services LLC

  • Professional Counselor
  • Clarksville, TN
  • NPI 1780191114
  NPD (past)

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

{
    "created_epoch": "1627689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1235802513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 DUNBAR CAVE RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438828",
            "telephone_number": "931-249-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 DUNBAR CAVE RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438828",
            "telephone_number": "931-249-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "JACOB",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "M.S., NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-31",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Medical Group of Clarksville PLLC
• Elite Primary Care LLC (Elite Primary Care)
• Rebecca Kaitlin Elkins
• William E. Elkins Jr., PA-C
• Rhonda D. Elliott-Nick, RN
• Tiffany Elliott, M.S., CCC-SLP
• Allison Ellis
• Amanda Nicole Ellis, MPH. MSW
• Amy Ellis
• Amy Leigh Ellis, CPHT

• Mental Health Counselor in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.