Jatarra Ellis, LPC-A

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6792 Issued in CT

Practice address

255 Bank St FL 4
Waterbury, CT 06702-2219

Phone

(203) 596-9724

NPI assigned

Mar 20, 2024

Sex

Female

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

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 and National Provider Directory roles.

• Community Mental Health Affiliates Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New Britain, CT
  • NPI 1174624423
  NPD

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1336909035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 BANK ST FL 4",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022219",
            "telephone_number": "203-596-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 BANK ST FL 4",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022219",
            "telephone_number": "203-596-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JATARRA",
        "credential": "LPC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-20",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "6792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elias C Deros DMD LLC
• Nicole Elias-Rivadeneira
• Amalfi Elibo
• Yisroel Elin, P.T.
• Jann Draper Elliott, OTR/L
• Leonard Ellis
• Elshaddai Health Care LLC
• David Elson, MD
• Elton Wellness Inc
• Janice J Elwell, APRN

• Mental Health Counselor in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.

Verify at the official NPI Registry.