Kathleen Ellis, PHD, LADC, LPC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

000903 Issued in CT

Practice address

365 Montauk Ave
New London, CT 06320-4700

Phone

(860) 271-4271

Fax

(860) 444-5107

NPI assigned

Nov 4, 2013

Sex

Female

Sole proprietor

Yes

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

Enrolled in CT2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

86.54

Promoting interoperability

99.98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  Medicare reassignment Care Compare group NPD
• Mill Hill Medical Consultants Inc

  • Hospitalist Physician
  • New Haven, CT
  • NPI 1952624769
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lawrence and Memorial Hospital, Inc.

  • General Acute Care Hospital
  • New London, CT
  • NPI 1073530879
  Care Compare affiliation
• Lawrence and Memorial Hospital, Inc.

  • General Acute Care Hospital
  • New London, CT
  • NPI 1700092459
  Care Compare affiliation

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1679902316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-271-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-271-4271",
            "fax_number": "860-444-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "PHD, LADC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000903",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "002541",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asim Ejaz, M.D.
• Alexander James Ejzak, P.A.
• Virginie Eklund
• Elliot H Kimmel & Associates PC
• Ashlyn Elliott, MSW
• Kevin Embree, PHARM.D.
• Empathy Psychotherapy
• Empowering Connections LLC
• Endodontics PC
• Stephanie Marie Eosten Joyce, M.D.

• Addiction (Substance Use Disorder) Counselor in New London, CT
• Providers in New London, CT by specialty
• Addiction (Substance Use Disorder) Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; 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.