Elishia L. Pulliam, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

503-226 Issued in WI

Practice address

1720 W Florist Ave Ste 301
Glendale, WI 53209-3800

Phone

(414) 247-0801

Fax

(414) 247-0816

NPI assigned

Jun 15, 2009

Sex

Female

Sole proprietor

Yes

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 WI

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Ryvan Counseling Services, LLC

  • Professional Counselor
  • Wauwatosa, WI
  • NPI 1942045224
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1710114095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 N MAYFAIR RD STE 101",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263432",
            "telephone_number": "414-375-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 W FLORIST AVE STE 301",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532093800",
            "telephone_number": "414-247-0801",
            "fax_number": "414-247-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLIAM",
        "first_name": "ELISHIA",
        "middle_name": "L.",
        "name_prefix": "Miss",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "503-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Family Medical Clinic S.C
• Providence Family Pharmacy LLC
• Providence Pharmacy & Wellness
• Renata B Ptak, PA-C
• Joseph Puccinelli, M.D.
• Mary A. Quinn, DDS
• R.E.a.C.H. Inc. Comprehensive Mental Health Clinic
• RDC Pharmacy LLC
• Reconnections
• Barbara Unger Rector, PT

• Professional Counselor in Glendale, WI
• Providers in Glendale, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.