NPIMap

Organization Active NPI

Ljak Enterprises LLC

  • Mental Health Counselor
  • Pensacola, FL
National Provider Identifier
1942992029
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LJAK ENTERPRISES LLC
Doing business as
Ellie Mental Health - NW Florida
Practice address
8354 N Davis Hwy
Suite 200
Pensacola, FL 32514
Phone
(850) 516-5592
NPI assigned
May 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Authorized official

Name
Ronald Kennedy
Title
Owner
Phone
(850) 516-5592

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

8354 N Davis Hwy
Suite 200
Pensacola, FL 32514

Mailing address

5629 Preakness CT
Pace, FL 32571-6378
Phone (850) 516-5592

Other names 1

  • Ellie Mental Health - NW Florida Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240822002456 FL Part B Supplier - Clinic/Group Practice 3971042938 Receives reassigned benefits from 2 practitioners
Practice locations: Pensacola, FL

National Provider Directory

National Provider Directory

Locations

8354 N Davis Hwy
Ste 200
Pensacola, FL 32514
Phone (850) 516-5592

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1942992029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5629 PREAKNESS CT",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325716378",
            "telephone_number": "850-516-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8354 N DAVIS HWY",
            "address_2": "SUITE 200",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32514",
            "telephone_number": "850-516-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LJAK ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-516-5592"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellie Mental Health - NW Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.