Michelle Matson Ellis, MACP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60742082 Issued in WA

Practice address

1809 Commercial Ave Ste 207
Anacortes, WA 98221-2326

Phone

(425) 892-4997

Fax

(425) 952-6918

NPI assigned

Apr 1, 2015

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

Other names 1

• Michelle Kay Matson Former name

Medicare fee-for-service enrollment

Enrolled in WA

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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 and National Provider Directory roles.

• Vivere Therapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Anacortes, WA
  • NPI 1306796982
  NPD Authorized official

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1659766186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4518 SCHOONER DR",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982214060",
            "telephone_number": "206-890-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 COMMERCIAL AVE STE 207",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212326",
            "telephone_number": "425-892-4997",
            "fax_number": "425-952-6918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 State St S",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980336667",
            "country_code": "US",
            "telephone_number": "425-892-4997",
            "fax_number": "425-952-6918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MICHELLE",
        "middle_name": "MATSON",
        "credential": "MACP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60742082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MATSON",
            "middle_name": "KAY",
            "credential": "MACP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Breonna Edwards
• Holle Ann Edwards, SUDP
• Susan L Edwards, MSW, LICSW
• Nicolas Alfonso Elizondo
• Kenneth R Ellis, MD
• Elmm Clinic
• Daniel Enselman, LMHC, CDP
• John W Fabianek, D.C.
• Family Care Network PLLC (Island Family Physicians)
• Family Care Network PLLC (FCN Draw Station - Island Family Physicians)

• Mental Health Counselor in Anacortes, WA
• Providers in Anacortes, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; 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.