Ellene Funke, LPC, CAADC, ATR, SCL

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401011779 Issued in MI

Practice address

114 Orchard Lake Rd
Pontiac, MI 48341-2244

Phone

(248) 858-7766

NPI assigned

Feb 16, 2010

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

Other names 1

• Ellene Corace Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388620800000",
    "number": "1700108917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 ORCHARD LAKE RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412244",
            "telephone_number": "248-858-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 ORCHARD LAKE RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412244",
            "telephone_number": "248-858-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNKE",
        "first_name": "ELLENE",
        "credential": "LPC, CAADC, ATR, SCL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-16",
        "last_updated": "2014-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6401011779",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401011779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLENE",
            "last_name": "CORACE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mariana Freitez Banks
• Viannette Frias-Lopez
• Chelsey Frommer, RCP
• Dana Marie Fuller, MA, LPC
• Laura A Fuller, MS, LPC, ATR
• James W Furlong, MD
• Alexandra Elizabeth Gabridge
• Jonathan Gaduski, DO
• Mary Lou Gagnon, CRNA
• Ravali Gali

• Professional Counselor in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.