Individual provider Active NPI

Ellen Hollister-Breen

  • Mental Health Counselor
  • Watertown, NY
National Provider Identifier
1427813864
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
18-P133171-01 Issued in NY
Practice address
650 State St
Watertown, NY 13601-2839
Phone
(315) 755-1251
Fax
(315) 291-6601
NPI assigned
Feb 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 18-P133171-01 NY Primary

Addresses

Primary practice location

650 State St
Watertown, NY 13601-2839

Mailing address

324 County Route 51 BLDG 1
Malone, NY 12953-4502
Phone (518) 483-1251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18-P133171-01NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen Advocates, Inc CurrentSince Sep 8, 2025 Accepting new patients

Locations

324 County Route 51
#1
Malone, NY 12953

650 State St
Watertown, NY 13601
Phone (315) 755-1251

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1427813864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 COUNTY ROUTE 51 BLDG 1",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129534502",
            "telephone_number": "518-483-1251",
            "fax_number": "518-483-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 STATE ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012839",
            "telephone_number": "315-755-1251",
            "fax_number": "315-291-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLISTER-BREEN",
        "first_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-15",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "18-P133171-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.