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ELLIS THERAPEUTIC SERVICES NPI 1609453307


NPI Information

NPI: 1609453307
Provider Name: ELLIS THERAPEUTIC SERVICES
Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
16116 INVERRARY LN
BLOOMINGTON, IL
ZIP 61705
Phone: (309) 830-3968
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ELLIS THERAPEUTIC SERVICES is a counselor in Bloomington, IL. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. ELLIS THERAPEUTIC SERVICES NPI is 1609453307. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

16116 INVERRARY LN
BLOOMINGTON, IL
ZIP 61705-580
Phone: (309) 830-3968

The provider's authorized official is Thelma Carpenter-ellis .
The authorized official title is Ceo/owner and has the following contact phone number (309) 830-3968.

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


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental HealthNo
2101YP1600XCounselorPastoralNo
3101YP2500XCounselorProfessionalNo
4101Y00000XCounselorYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.