Active NPI
Jamilyn Rose Ellis
- Mental Health Counselor
- Yakima, WA
National Provider Identifier
1952435190
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.
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH60637336
- Practice address
- 402 S 4TH Ave
Yakima, WA 98902-3546 - Phone
- (509) 575-4084
- NPI assigned
- Mar 16, 2007
- Last updated
- Mar 10, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG60144021 | WA | MD | Counselor |
| LH60637336 | WA | MD | Mental 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.