Active NPI
Gini M Ellis, LPC, NCC
- Professional Counselor
- Milledgeville, GA
National Provider Identifier
1629619945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC009485
- Practice address
- Blandy Way Office Park 60, Highway 22 West
Milledgeville, GA 31061 - Phone
- (478) 451-2700
- NPI assigned
- Oct 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC009485 | GA | Primary |
Addresses
Primary practice location
Blandy Way Office Park 60, Highway 22 West
Milledgeville, GA 31061
Mailing address
Blandy Way Office Park 60, Highway 22 West
Milledgeville, GA 31061
Phone (478) 451-2700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC009485 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570492800000",
"number": "1629619945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BLANDY WAY OFFICE PARK 60, HIGHWAY 22 WEST",
"city": "MILLEDGEVILLE",
"state": "GA",
"postal_code": "31061",
"telephone_number": "478-451-2700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BLANDY WAY OFFICE PARK 60, HIGHWAY 22 WEST",
"city": "MILLEDGEVILLE",
"state": "GA",
"postal_code": "31061",
"telephone_number": "478-451-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "GINI",
"middle_name": "M",
"credential": "LPC, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-08",
"last_updated": "2019-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC009485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milledgeville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.