Colleen Elizabeth Ellis, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00531400 Issued in NJ

Practice address

20 E Clinton Ave
Haddon Township, NJ 08107-1355

Phone

(215) 603-2851

NPI assigned

Nov 16, 2011

Last updated

Jun 11, 2013By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1407123672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 E CLINTON AVE",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081071355",
            "telephone_number": "215-603-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E CLINTON AVE",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081071355",
            "telephone_number": "215-603-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "COLLEEN",
        "middle_name": "ELIZABETH",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-16",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00531400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Haddon Township, NJ
• Providers in Haddon Township, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.