NATHAN CODY ELLIS LCPC - NPI 1154609998

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

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About Nathan Cody Ellis Lcpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NATHAN CODY ELLIS LCPC (NPI 1154609998) is an individual mental health provider in Boise, Idaho, licensed in Idaho (LCPC-7528) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS, maintains a secondary practice location in Boise, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1154609998

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameNATHAN CODY ELLISCredential: LCPC

Location Address703 S AMERICANA BLVD STE 150Boise, ID 83702-4976

Mailing AddressPo Box 9Nampa, ID 83653-0009 · (208) 461-7149 · Fax (208) 467-3391

Phone(208) 706-6375

Fax(208) 706-6395

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateJuly 27, 2011

Last NPPES UpdateJune 8, 20223 updates tracked since enumeration

NPPES CertifiedJune 8, 2022

✔ NPI 1154609998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

Licenses✔ Licensed in ID · LCPC-7528✔ Licensed in ID · 4858

Also ListedCounselorTaxonomy 101Y00000X · License 4858 (ID)

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 4858 (ID)

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License LCPC-7528 (ID), 4858 (ID)

Also ListedPsychoanalystTaxonomy 102L00000X · License 4858 (ID)

703 S AMERICANA BLVD STE 150, Boise, ID 83702

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Secondary Practice Location 1

Location 1300 S 23rd StBoise, ID 83702-9100 · Phone (208) 344-3512 · Fax (208) 466-5359

Other Identifiers 1

Other1091972National Board Of Certified Counselors Inc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nathan Cody Ellis Lcpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5294171153

PECOS Enrollment IDI20240313003553

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.