JACQUELINE C ELLIS LPC
NPI 1417129859
Counselor - Professional in Americus, GA
About Jacqueline C Ellis Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACQUELINE C ELLIS LPC (NPI 1417129859) is an individual professional provider in Americus, Georgia, licensed in Georgia (LPC004305) and active in the NPI registry since March 2008. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jacqueline C Ellis Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jacqueline Ellis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Americus, GA 31709
- Reassigned Medicare billing, Georgia enrollment
- 24 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
AMERICUS, GA 31709
AMERICUS, GA 31709
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 Jacqueline Ellis's NPI number?
The NPI number for Jacqueline Ellis is 1417129859. It was assigned to this individual provider in the NPPES registry on March 26, 2008.
Where is Jacqueline Ellis located?
Jacqueline Ellis practices at 415 N Jackson St P.O. Drawer 1348, Americus, GA 31709. The listed phone number is (229) 931-2470.
What is Jacqueline Ellis's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Jacqueline Ellis enrolled in Medicare?
Yes. Jacqueline Ellis is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jacqueline Ellis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Ellis reassigns Medicare benefits to Middle Flint Area Community Service Board (Americus, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacqueline Ellis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jacqueline Ellis was last updated on March 26, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.
# Jacqueline C Ellis, LPC · NPI 1417129859
Professional provider in Americus, Georgia. Individual provider, active in the CMS NPPES registry since March 26, 2008.
## Identity
- **NPI:** 1417129859 (Entity type: Individual)
- **Enumerated:** March 26, 2008
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** LPC004305 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 415 N JACKSON ST, P.O. DRAWER 1348, Americus, GA 31709-3015
- **Phone:** (229) 931-2470 · **Fax:** (229) 931-2474
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Middle Flint Area Community Service Board (NPI 1093784720, Americus, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 26, 2008
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Source: [NPI Profile](https://npiprofile.com/npi/1417129859) · Data from the CMS NPPES public registry.