Paul Nathaneal Ellingsen Jr., MFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MFC37066 Issued in CA

Practice address

623 Willowspring Dr S
Encinitas, CA 92024-4136

Phone

(858) 736-4099

Fax

(760) 942-9597

NPI assigned

Nov 8, 2006

Sex

Male

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 CA

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

Medicare enrollment (NPD)

Enrolled

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.

• Segal Telepsychiatry Network

  • Psychoanalyst
  • Mill Valley, CA
  • NPI 1245529296
  Medicare reassignment NPD
• Segal Telepsychiatry Network, PLLC

  • Psychiatry Physician
  • Mill Valley, CA
  • NPI 1518674852
  NPD

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801966825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 WILLOWSPRING DR S",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244136",
            "telephone_number": "858-736-4099",
            "fax_number": "760-942-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 WILLOWSPRING DR S",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244136",
            "telephone_number": "858-736-4099",
            "fax_number": "760-942-9597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGSEN",
        "first_name": "PAUL",
        "middle_name": "NATHANEAL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC37066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Jane Eldean, MA, MFT
• Eleonora Vince, Physical Therapy Inc.
• Ashraf Elhofy
• Elite Health and Beauty LLC
• Brittney Ellers, DPT
• Adam P Ellis, M.D.
• Daria Emelianova, MD
• Emergency and Acute Care Medical Corporation
• Emergency Medicine Group of Encinitas, Inc
• Amy Emery, AMFT

• Mental Health Counselor in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.