Crystal Dawn Ellison

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

15755 Parkway LN Apt 1
Southgate, MI 48195-4739

Phone

(313) 432-8885

NPI assigned

Jan 15, 2026

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

Practice roles

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.

• Trust the Change

  • Community/Behavioral Health Agency
  • Southgate, MI
  • NPI 1346928405
  NPD Authorized official

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

{
    "created_epoch": "1768435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1578422671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15755 PARKWAY LN APT 1",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481954739",
            "telephone_number": "313-432-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15755 PARKWAY LN APT 1",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481954739",
            "telephone_number": "313-432-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "CRYSTAL",
        "middle_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-15",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kassem Hamze Elhelou, PHARMD
• Elixir Pharmacy 2
• Chelsea Ellis, PA-C
• Melanie Ellis
• Tamara Reneise Ellis, LLBSW
• James Ellsworth
• Elizabeth Elster
• Emily Elston, O.D
• Krishawn Emadamerho, OTR
• Jared Emerson, DO

• Community/Behavioral Health Agency in Southgate, MI
• Providers in Southgate, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.