NATHAN CODY ELLIS LCPC NPI 1154609998

NPI Information

NPI: 1154609998
Provider Name: NATHAN CODY ELLIS, LCPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
2850 INDUSTRIAL WAY
MOUNTAIN HOME, ID
ZIP 83647
Phone: (208) 872-6795
Get Directions

Nathan Cody Ellis, LCPC is a professional counselor in Mountain Home, ID. Nathan Cody Ellis, LCPC NPI is 1154609998. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2850 INDUSTRIAL WAY
MOUNTAIN HOME, ID
ZIP 83647-960
Phone: (208) 872-6795
Fax: (208) 587-2875

The enumeration date for this NPI number is 7/27/2011 and was last updated on 3/15/2021.

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
1	101Y00000X	Counselor		4858	IDAHO	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	4858	IDAHO	No
3	101YM0800X	Counselor	Mental Health	LCPC-7528	IDAHO	No
4	101YM0800X	Counselor	Mental Health	4858	IDAHO	No
5	101YP2500X	Counselor	Professional	4858	IDAHO	Yes
6	101YP2500X	Counselor	Professional	LCPC-7528	IDAHO	No
7	102L00000X	Psychoanalyst		4858	IDAHO	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	LCPC-7528	OTHER	IDAHO	IDAHO BUREAU OF OCCUPATIONAL LICENSING
2	1091972	OTHER		NATIONAL BOARD FOR CERTIFIED COUNSELORS INC

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: 11/14/2023

NPI Synchronization or Removal

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