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NPI Code Detail

MEDICARE: LEXI ELLIS MA, LPC

MEDICARE: LEXI ELLIS MA, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLPC.0013842CO

General Provider Information

NPI Number : 1285157321
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEXI ELLIS MA, LPC
Provider Business Mailing Address
First Line : 4975 AUSTIN BLUFFS PKWY
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-5043
Country : US
Telephone Number : 720-255-9283
Fax Number :
Provider Business Practice Location Address
First Line : 4975 AUSTIN BLUFFS PKWY
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-5043
Country : US
Telephone Number : 720-255-9283
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2017
Last Update Date : 10/02/2023

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