Individual provider Active NPI

Jamilyn Rose Ellis

  • Mental Health Counselor
  • Yakima, WA
National Provider Identifier
1952435190
Registry record updated Mar 10, 2016
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(4) exclusion effective Nov 20, 2022.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60637336 Issued in WA
Practice address
402 S 4TH Ave
Yakima, WA 98902-3546
Phone
(509) 575-4084
NPI assigned
Mar 16, 2007
Last updated
Mar 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CG60144021 WA
Mental Health Counselor 101YM0800X LH60637336 WA Primary

Addresses

Primary practice location

402 S 4TH Ave
Yakima, WA 98902-3546

Mailing address

PO Box 959
Yakima, WA 98907-0959
Phone (509) 575-4084

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
CG60144021WAMDCounselor
LH60637336WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457568000000",
    "number": "1952435190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989070959",
            "telephone_number": "509-575-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S 4TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023546",
            "telephone_number": "509-575-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JAMILYN",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2016-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG60144021",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60637336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.