Active NPI
Samantha Ellis
- Counselor
- Royal Oak, MI
National Provider Identifier
1811417736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401018939
- Practice address
- 709 N Washington Ave
Royal Oak, MI 48067-1735 - Phone
- (248) 541-7100
- NPI assigned
- Jun 21, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401018939 | MI | Primary |
Addresses
Primary practice location
709 N Washington Ave
Royal Oak, MI 48067-1735
Mailing address
41682 Winter CT
Canton, MI 48187
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1811417736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41682 WINTER CT",
"city": "CANTON",
"state": "MI",
"postal_code": "48187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 N WASHINGTON AVE",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480671735",
"telephone_number": "248-541-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-21",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401018939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.