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DR. KATHLEEN ELLIS PHD, LADC, LPC
NPI 1679902316
Counselor - Addiction (Substance Use Disorder) in New London, CT

Active since November 04, 2013PECOS EnrolledAccepts Medicare Assignment
93.27/100
CMS Quality Rating
365 MONTAUK AVE, NEW LONDON, CT 06320(860) 271-4271(860) 444-5107 Get Directions Write a Review

NPPES record last updated: September 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kathleen Ellis Phd, Ladc, Lpc NPPES

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

DR. KATHLEEN ELLIS PHD, LADC, LPC (NPI 1679902316) is an individual addiction (substance use disorder) provider in New London, Connecticut, licensed in Connecticut (000903) and active in the NPI registry since November 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1679902316
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameDR. KATHLEEN ELLISCredential: PHD, LADC, LPC
Location Address365 MONTAUK AVENew London, CT 06320-4700
Mailing Address365 Montauk AveNew London, CT 06320-4700 · (860) 271-4271
Phone(860) 271-4271
Fax(860) 444-5107
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateNovember 4, 2013
Last NPPES UpdateSeptember 10, 2025
NPPES CertifiedSeptember 10, 2025
✔ NPI 1679902316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CT · 000903
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 002541 (CT)
365 MONTAUK AVE, New London, CT 06320
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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

Dr. Kathleen Ellis Phd, Ladc, Lpc 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 ID9739309758
PECOS Enrollment IDI20140925000833, I20240215000203
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.27/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.72
Promoting Interoperability78.03
Improvement Activities40

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.

KATHLEEN M PACHECO RN, CDE
Registered Nurse (Diabetes Educator)
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 444-4737
THERESA M. BONANOMI
Social Worker (Clinical)
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 444-5141
AMIT KHANNA MD
Family Medicine (Sleep Medicine)
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 442-0711
JOANN DONNEL LNM
Advanced Practice Midwife
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 442-0711
SAMUEL MARYLES MD
Emergency Medicine
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (330) 493-4443
DR. PAUL CASINELLI M.D
Anesthesiology
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 442-0711
MARIAM F. ABOUKAR D.O.
Psychiatry & Neurology (Psychiatry)
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 442-0711
MR. STEPHEN DANIEL SOCHA FNP-C
Nurse Practitioner (Family)
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 442-0711

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 Kathleen Ellis's NPI number?

The NPI number for Kathleen Ellis is 1679902316. It was assigned to this individual provider in the NPPES registry on November 4, 2013.

Where is Kathleen Ellis located?

Kathleen Ellis practices at 365 Montauk Ave, New London, CT 06320. The listed phone number is (860) 271-4271.

What is Kathleen Ellis's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Kathleen Ellis enrolled in Medicare?

Yes. Kathleen Ellis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kathleen Ellis was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.