Larry Ellis, M.S.W.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

129151-121 Issued in WI

Practice address

11104 W Meadow Creek Dr
Milwaukee, WI 53224-5053

Phone

(414) 461-3134

Fax

(414) 393-6222

NPI assigned

Apr 8, 2014

Sex

Male

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

State licenses

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1437578366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11104 W MEADOW CREEK DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532245053",
            "telephone_number": "414-461-3134",
            "fax_number": "414-393-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 W MEADOW CREEK DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532245053",
            "telephone_number": "414-461-3134",
            "fax_number": "414-393-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "LARRY",
        "name_prefix": "Mr.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "129151-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Ellis, MD
• Eddie Ellis
• Jarmaine Lee Ellis, LPN
• Jodie Lynn Ellis, MSW
• Katrina Karetha Ellis, LICENSED PRACTICAL
• Mary Kathryn Ellis, MD
• Nea D Ellis, RN
• Rachel Antoinette Ellis
• Robyn Stephanie Ellis, BSW
• Stephen Ellis, APNP

• Mental Health Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; 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.