Michael Ethen Ellison

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2300 Northpoint Pkwy
Santa Rosa, CA 95407-5004

Phone

(707) 571-8452

NPI assigned

Nov 30, 2022

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1316657349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 NORTHPOINT PKWY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075004",
            "telephone_number": "707-571-8452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 NORTHPOINT PKWY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075004",
            "telephone_number": "707-571-8452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "MICHAEL",
        "middle_name": "ETHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-30",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liam Kenneth Elliott, FNP
• Lisa Elsie Elliott, AMFT
• Patricia Clare Ellis-Christensen, LMFT
• Lisa Joanne Ellis
• Sara Ellis
• Erin Elo
• Kirk Elrod
• Garrett Joesph Elsberry
• Kelly Ann Elward, D.D.S.
• Elyse R. Eisenberg MD, Inc.

• Mental Health Counselor in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.