Amina Ellrott, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00872200 Issued in NJ

Practice address

9 Polk St
Sparta, NJ 07871-2713

Phone

(862) 261-0222

NPI assigned

May 1, 2019

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

Medicare fee-for-service enrollment

Enrolled in NJ

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellness HouseGroup PAC ID 0042751455, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealthnj.aminaellrott@148376.advancedmd-direct.com

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.

• Wellness House

  • Clinical Social Worker
  • Augusta, NJ
  • NPI 1932950441

  Professional

  Medicare reassignment Care Compare group NPD
• PHC of Buffalo Grove Clinical Psychology

  dba Portrait Health Centers

  • Psychologist
  • Vernon Hills, IL
  • NPI 1235430612
  NPD (past)

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725667200000",
    "number": "1700441193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 WALL ST W STE 310",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070713615",
            "telephone_number": "732-982-2888",
            "fax_number": "732-694-7622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 POLK ST",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078712713",
            "telephone_number": "862-261-0222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Wall St W Ste 310",
            "address_purpose": "LOCATION",
            "city": "Lyndhurst",
            "state": "NJ",
            "postal_code": "070713615",
            "country_code": "US",
            "telephone_number": "732-982-2888",
            "fax_number": "847-859-5885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLROTT",
        "first_name": "AMINA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-01",
        "last_updated": "2024-09-07",
        "certification_date": "2024-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00872200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Javier Alcid Duron Tabora, MD
• Katherine Grace Dymacz, NP
• Ebb Flow Grow LLC
• Rebecca Fox Eisen
• Elizabeth Ellis, LPC
• Emma Quigley, DMD, LLC
• Jenna Eoga, PT, DPT
• Ebony Erickson
• Neysa Etienne, LMFT
• Andrew Michael Evans, DPT

• Professional Counselor in Sparta, NJ
• Providers in Sparta, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2024; 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.