Ellice Park LLC Dba Counseling Care Circle

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ELLICE PARK LLC DBA COUNSELING CARE CIRCLE

Practice address

180 E Broad St
Columbus, OH 43215-3707

Phone

(614) 568-3233

NPI assigned

Sep 3, 2021

Organization subpart

No

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

Authorized official

Name

Virtual Mustard Seed

Title

Agent

Phone

(614) 568-3233

Specialties & licenses 15

Addresses

Other names 1

• Ellice Park LLC Other name

Locations

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778284800000",
    "number": "1457029373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2465",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171052465",
            "telephone_number": "614-568-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432153707",
            "telephone_number": "614-568-3233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4449 Easton Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432197005",
            "country_code": "US",
            "telephone_number": "614-568-3233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 S 3rd St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154206",
            "country_code": "US",
            "telephone_number": "614-568-3233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELLICE PARK LLC DBA COUNSELING CARE CIRCLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-03",
        "last_updated": "2026-05-09",
        "certification_date": "2026-05-09",
        "status": "A",
        "authorized_official_last_name": "SEED",
        "authorized_official_first_name": "VIRTUAL",
        "authorized_official_middle_name": "MUSTARD",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "614-568-3233"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282J00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Health Care Institution",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Religious Nonmedical Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellice Park LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kaitlyn M Eller
• Alex David Ellerhorst, DO
• Simone Sheree Ellerson
• Ameya Elleston
• Haley M Ellett, CPNP-PC
• Kathleen A Ellickson, PHD
• Pamela S Ellinger-Dixon, PH.D.
• Mitchell Ellinger, MS, RN, CPNP
• Hannah Ellingson
• David M. Elliot, APRN-CRNA

• Multi-Specialty Clinic/Center in Columbus, OH
• Providers in Columbus, OH by specialty
• Multi-Specialty Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2026; 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.