MIA ELLIS LCPC
NPI 1164178588
Counselor - Mental Health in Ellicott City, MD
About Mia Ellis Lcpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MIA ELLIS LCPC (NPI 1164178588) is an individual mental health provider in Ellicott City, Maryland, licensed in Maryland (LC14726) and active in the NPI registry since February 2022. She has opted out of Medicare through November 10, 2027.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Mia Ellis Lcpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 10, 2025 through November 10, 2027.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ELLICOTT CITY, MD 21042
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mia Ellis's NPI number?
The NPI number for Mia Ellis is 1164178588. It was assigned to this individual provider in the NPPES registry on February 24, 2022.
Where is Mia Ellis located?
Mia Ellis practices at 5116 Dorsey Hall Dr, Ellicott City, MD 21042. The listed phone number is (443) 745-8062.
What is Mia Ellis's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Mia Ellis enrolled in Medicare?
No. Mia Ellis has opted out of Medicare through November 10, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Mia Ellis was last updated on October 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mia Ellis, LCPC · NPI 1164178588
Mental Health provider in Ellicott City, Maryland. Individual provider, active in the CMS NPPES registry since February 24, 2022.
## Identity
- **NPI:** 1164178588 (Entity type: Individual)
- **Enumerated:** February 24, 2022
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** LC14726 (Maryland)
- **Sole proprietor:** No
## Practice location
- **Address:** 5116 DORSEY HALL DR, Ellicott City, MD 21042-7871
- **Phone:** (443) 745-8062
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through November 10, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** October 31, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1164178588) · Data from the CMS NPPES public registry.