Alicia A Elliott, CNS

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

71003708A Issued in IN

Practice address

1910 Saint Joe Center Rd Ste 23
Fort Wayne, IN 46825-5000

Phone

(260) 414-4025

Fax

(260) 484-5664

NPI assigned

Jan 31, 2011

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 2

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dunn Associates PCGroup PAC ID 0648376210, 3 clinicians

Live Heal Grow Counseling ServicesGroup PAC ID 0547665325, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

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.

• Live Heal Grow Counseling Services

  • Mental Health Counselor
  • Columbia City, IN
  • NPI 1780274712
  Medicare reassignment Care Compare group NPD
• Dunn Associates PC

  • Mental Health Counselor
  • Fort Wayne, IN
  • NPI 1740362391
  Medicare reassignment Care Compare group
• Park Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1306897004
  Medicare reassignment NPD
• Elevation Enterprises, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1538932728
  NPD
• Park Center Inc

  • Psychiatric Hospital
  • Fort Wayne, IN
  • NPI 1457772402
  NPD

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

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1699071100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 ST JOE CTR RD #23",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SAINT JOE CENTER RD STE 23",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255000",
            "telephone_number": "260-414-4025",
            "fax_number": "260-484-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "ALICIA",
        "middle_name": "A",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-31",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71003708A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000730490",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201033980",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derek Ellingson, D.O.
• Patrice C Ellingson, O.D.
• Julia A. Ellingwood, FNP-C
• Charles Chase Ellinwood, DDS
• Steven Penn Ellinwood, DDS
• Ann Natasha Elliott, FNP-C
• Brittany L Elliott, BT
• Chad Elliott, DO
• Charlotte Elliott, LCSW
• Gail B Elliott, PT

• Psychiatric/Mental Health Clinical Nurse Specialist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.