Carolyn Ilona Ellis, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH6728 Issued in FL

Practice address

3001 Aloma Ave Ste 214
Winter Park, FL 32792-3752

Phone

(407) 538-7984

NPI assigned

Jun 3, 2009

Last updated

Jun 3, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Mental Health Counselor

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Beth Davalos Counseling Center LLCGroup PAC ID 3375978414, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Beth Davalos Counseling Center LLC

  dba Sunshine Senior Counseling

  • Clinical Social Worker
  • Maitland, FL
  • NPI 1932760451

  Mental Health

  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932
  Medicare reassignment NPD

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243987200000",
    "number": "1588890677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 PONDEROSA AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327922064",
            "telephone_number": "407-538-7984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 ALOMA AVE STE 214",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923752",
            "telephone_number": "407-538-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CAROLYN",
        "middle_name": "ILONA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2009-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "763805100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Elery
• Elite Sports & Wellness LLC
• Elizabeth T Hunter MD PA
• Shayna Anne Ellery
• Marci Lynn Elliott, LMHC
• Jennifer Jan Ellis, ATC
• Katherine Hope Ellison
• Ellpic, LLC (Visiting Angels of Orlando Winter Park)
• Hannah Noelle Ellwood, APRN
• Autumn Faith Elms, MD

• Mental Health Counselor in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.