Tenneille Ely, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

3716 W Brighton Ave
Peoria, IL 61615-2938

Phone

(309) 692-7755

NPI assigned

Jan 18, 2023

Last updated

Jan 18, 2023By 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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• John Day & Associates, LTD

  • Clinical Psychologist
  • Peoria, IL
  • NPI 1245454313

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1508571019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 W BRIGHTON AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152938",
            "telephone_number": "309-692-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 W BRIGHTON AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152938",
            "telephone_number": "309-692-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "TENNEILLE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Elschlager, ATC
• Luke Elsener
• Brian Arthur Elsesser, CRNA
• Patrick William Elwood, MD
• Jami Elizabeth Ely, M.A., BCBA
• Vamsi K Emani, M.D.
• Jessica Marie Embry, APN
• Madison Lynn Embry
• Emily Trulson, LCPC Counseling Services LLC
• Empowering People Inspiring Capabilities, Inc. (Epic)

• Marriage & Family Therapist in Peoria, IL
• Providers in Peoria, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.