Alicia Michelle Ellis, ED.D., LPC-MHSP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2938 Issued in TN

Practice address

10543 Cedar Grove Rd
Smyrna, TN 37167-6525

Phone

(615) 905-6321

NPI assigned

Sep 26, 2013

Last updated

Apr 23, 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

Practice roles

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.

• Itavia's House of Care LLC

  • In Home Supportive Care Agency
  • Smyrna, TN
  • NPI 1083284814
  NPD Authorized official
• Perry County Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Linden, TN
  • NPI 1154322303
  NPD (past)

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1346677077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10543 CEDAR GROVE RD",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676525",
            "telephone_number": "615-905-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10543 CEDAR GROVE RD",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676525",
            "telephone_number": "615-905-6321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Cumberland Bnd",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372281805",
            "country_code": "US",
            "telephone_number": "615-726-3340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ALICIA",
        "middle_name": "MICHELLE",
        "credential": "ED.D., LPC-MHSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-26",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "2938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q034586",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Bennett Egger, PHARMD
• Caroline McMurtry Elcan
• Madyson Skye-Mae Ellard
• Caitlin O'Leary Elliott, FNP-C
• Susan E Elliott, FNP-C
• Stephanie Elizabeth Ellis
• Emerald Group LLC (The Waterford Of Smyrna)
• Emerald Primary Care and Wellness Clinic (Emerald Primary Care and Wellness Clinic, PLLC)
• Lily Emerson
• Eminence Care LLC

• Mental Health Counselor in Smyrna, TN
• Providers in Smyrna, 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 Apr 23, 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.