Jennifer Ellis, M.Ed, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PC006176 Issued in PA

Legal business name

JENNIFER ELLIS, M.ED, LPC

Practice address

464 Parker Ave
Philadelphia, PA 19128-4402

Phone

(609) 413-6089

NPI assigned

Nov 23, 2014

Last updated

Nov 23, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Marie Ellis, LPCNPI 1316212913

Title

Licensed Professional Counselor

Phone

(609) 413-6089

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer M Ellis, LPC

  • Counselor
  • Collegeville, PA
  • NPI 1316212913
  Authorized official Same address or phone

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

{
    "created_epoch": "1416700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416700800000",
    "number": "1740687524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 PARKER AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191284402",
            "telephone_number": "609-413-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 PARKER AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191284402",
            "telephone_number": "609-413-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER ELLIS, M.ED, LPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-23",
        "last_updated": "2014-11-23",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "609-413-6089",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC006176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Catherine Dardenne Jennings, OD
• Chase A Jennings, MD

• Mental Health Counselor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Mental Health Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.