Stacey Jo Ellison, MS, LPC-IT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7516-226 Issued in WI

Practice address

2314 N Grandview Blvd Ste 207
Waukesha, WI 53188-1675

Phone

(262) 251-1112

NPI assigned

Sep 4, 2024

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 Science

State licenses

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

{
    "created_epoch": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1467287979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 N GRANDVIEW BLVD STE 207",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881675",
            "telephone_number": "262-251-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 N GRANDVIEW BLVD STE 207",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881675",
            "telephone_number": "262-251-1112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W156N8327 Pilgrim Rd Ste 309",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530513776",
            "country_code": "US",
            "telephone_number": "262-251-1112 x744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "STACEY",
        "middle_name": "JO",
        "credential": "MS, LPC-IT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "7516-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellefson Therapy LTD
• Ellenson Family Chiropractic LLC
• Nicholas Paul Ellenson, D.C.
• Peggy Ann Eller, RDH
• Katie Ellie
• Christine L Elmer, RN
• Chantel Else, RN
• Egwe Elvis Akeme
• Emergency Medical Associates LLP
• Empathia, Inc.

• Mental Health Counselor in Waukesha, WI
• Providers in Waukesha, 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 Sep 4, 2024; 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.