DR. MAVONNA MARIE ELLIS PHD NPI 1124064233

NPI Information

  • NPI: 1124064233
  • Provider Name: DR. MAVONNA MARIE ELLIS, PHD
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 1616 S AUGUST ST
    STILLWATER, OK
    ZIP 74074
  • Phone: (405) 564-0656

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NPI Details

DR. Mavonna Marie Ellis, PHD is a mental health counselor in Stillwater, OK. DR. Mavonna Marie Ellis, PHD NPI is 1124064233. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1616 S AUGUST ST
STILLWATER, OK
ZIP 74074-837
Phone: (405) 564-0656

The enumeration date for this NPI number is 6/20/2006 and was last updated on 10/15/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental Health3974OKLAHOMAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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