Provider Demographics
NPI:1124509971
Name:ELLIS GROUP COUNSELING
Entity type:Organization
Organization Name:ELLIS GROUP COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:K
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:254-300-6313
Mailing Address - Street 1:2118 BIRDCREEK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-1020
Mailing Address - Country:US
Mailing Address - Phone:254-300-6313
Mailing Address - Fax:
Practice Address - Street 1:2118 BIRDCREEK DR STE 100
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-1020
Practice Address - Country:US
Practice Address - Phone:254-300-6313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty