SUSAN ELLIS LPC
NPI 1285247114
Counselor - Mental Health in Germantown, WI

NPI Status: Active since August 29, 2020

Contact Information

W175N11163 STONEWOOD DR STE 106
GERMANTOWN, WI
ZIP 53022
Phone: (262) 345-4270

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  • Individual
  • Female
  • Counselor
  • Mental Health
  • Accepts Insurance
  • Opted-Out Medicare

About SUSAN ELLIS

This page provides the complete NPI Profile along with additional information for Susan Ellis, a provider established in Germantown, Wisconsin with a medical specialization in Counselor, focusing in mental health . The healthcare provider is registered in the NPI registry with number 1285247114 assigned on August 2020. The practitioner's primary taxonomy code is 101YM0800X. The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI
1285247114
Provider Name
SUSAN ELLIS LPC
Gender
Female
Entity Type
Individual
Location Address
W175N11163 STONEWOOD DR STE 106 GERMANTOWN, WI 53022
Location Phone
(262) 345-4270
Mailing Address
W175N11163 STONEWOOD DR STE 106 GERMANTOWN, WI 53022
Mailing Phone
(262) 345-4270
Is Sole Proprietor?
No
Enumeration Date
08-29-2020
Last Update Date
01-31-2023
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A mental health counselor like Susan Ellis provides treatment to individuals, families, couples, and groups for mental and emotional health issues and relationship problems. Mental health counselors treat clients with a variety of conditions, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses.

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Susan Ellis opted out of Medicare effective on 01-02-2024 until 01-02-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Counselor Mental Health

Taxonomy Code
101YM0800X
Type
Behavioral Health & Social Service Providers

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Engage by Medica Bronze HSA - EPO
  • Engage by Medica Bronze Share - EPO
  • Engage by Medica Expanded Bronze Standard - EPO
  • Engage by Medica Gold $0 Copay PCP Visits - EPO
  • Engage by Medica Gold Share - EPO
  • Engage by Medica Gold Standard - EPO
  • Engage by Medica Silver $0 Copay PCP Visits - EPO
  • Engage by Medica Silver Share - EPO
  • Engage by Medica Silver Standard - EPO
  • Essentia Choice Care with Medica Bronze HSA - EPO
  • Essentia Choice Care with Medica Bronze Share - EPO
  • Essentia Choice Care with Medica Expanded Bronze Standard - EPO
  • Essentia Choice Care with Medica Gold $0 Copay PCP Visits - EPO
  • Essentia Choice Care with Medica Gold Share - EPO
  • Essentia Choice Care with Medica Gold Standard - EPO
  • Essentia Choice Care with Medica Silver $0 Copay PCP Visits - EPO
  • Essentia Choice Care with Medica Silver Share - EPO
  • Essentia Choice Care with Medica Silver Standard - EPO
  • Medica Individual Choice Bronze HSA - EPO
  • Medica Individual Choice Bronze Share - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Silver Standard (No Referrals) - HMO
  • UHC Silver Value ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Value+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Opted-Out of Medicare? Yes

  • Opt-Out Effective Date: 01-02-2024

  • Opt-Out End Date: 01-02-2026

  • Eligible to Order and Refer? No

Reviews for SUSAN ELLIS LPC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1285247114, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
5
Unchanged
Pos 5
2
Doubled → 4
Pos 6
4
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
1
Unchanged
Pos 9
1
Doubled → 2
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 2 → 4 7 → 14 → 5 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 6 + 5 + 4 + 4 + 1 + 4 + 1 + 2 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1285247114.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285247114, enumerated as an "individual" on August 29, 2020.

The provider is located at W175N11163 STONEWOOD DR STE 106 GERMANTOWN, WI 53022 and the phone number is (262) 345-4270.

Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

The provider might be accepting Accepts: Medica and UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.