Logan Shontez Ellison, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

15796 Issued in NC

Practice address

5300 Atlantic Ave Ste 106C
Raleigh, NC 27609-1123

Phone

(919) 591-6257

NPI assigned

Aug 13, 2020

Last updated

Aug 15, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Clarity Connections Counseling, PLLC

  • Mental Health Counselor
  • Raleigh, NC
  • NPI 1114655347
  NPD Authorized official

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1679184626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 ATLANTIC AVE STE 106C",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276091123",
            "telephone_number": "919-791-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 ATLANTIC AVE STE 106C",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276091123",
            "telephone_number": "919-591-6257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "LOGAN",
        "middle_name": "SHONTEZ",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "15796",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tangela Ellis
• Ellison & Associates of Raleigh PC
• Brian Ellison, PHARM.D.
• Jenna Ellison, PHD
• Laniya Ellison
• Matthew David Ellison, M.D.
• Maxlyn Lavie Ellison, MD
• Lawrence A. Ellsworth, MSSW, LCSW
• Patricia Ellsworth
• Wagdy Abdelmonem Elmahdy, M.D.

• Mental Health Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.