Healthcare Provider Details

I. General information

NPI: 1447114525
Provider Name (Legal Business Name): JOSEPH S ELLIS MA, CAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7251 E 49TH AVE
COMMERCE CITY CO
80022-4714
US

IV. Provider business mailing address

7251 E 49TH AVE
COMMERCE CITY CO
80022-4714
US

V. Phone/Fax

Practice location:
  • Phone: 303-321-2533
  • Fax:
Mailing address:
  • Phone: 303-321-2533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACC.0998376
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: