JASON DEAN ELLIS LMFT
NPI 1720786031
Clinic/Center - Adolescent and Children Mental Health in Phoenix, AZ

Q: What is Jason Ellis's NPI number?

The NPI number for Jason Ellis is 1720786031. It was assigned to this individual provider in the NPPES registry on February 16, 2023.

Q: What is Jason Ellis's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

Q: When was this NPI record last updated?

The NPPES record for Jason Ellis was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since February 16, 2023

1102 E MISSOURI AVE, PHOENIX, AZ 85014(602) 999-8389(602) 613-4165 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: May 7, 2025, Feb 16, 2023 (2 updates tracked since 2023).

On this page

About Jason Dean Ellis Lmft NPPES

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

JASON DEAN ELLIS LMFT (NPI 1720786031) is an individual adolescent and children mental health provider in Phoenix, Arizona, licensed in Arizona (OTC13694) and active in the NPI registry since February 2023.

NPPES Registry Identity

NPI1720786031

Entity TypeIndividualMale

Primary Taxonomy261QM0855X

Provider Legal NameJASON DEAN ELLISCredential: LMFT

Location Address1102 E MISSOURI AVEPhoenix, AZ 85014-2708

Mailing Address1102 E Missouri AvePhoenix, AZ 85014-2708 · (602) 999-8389 · Fax (602) 613-4165

Phone(602) 999-8389

Fax(602) 613-4165

Sole ProprietorYes

Enumeration DateFebruary 16, 2023

Last NPPES UpdateMay 7, 20252 updates tracked since enumeration

NPPES CertifiedMay 7, 2025

✔ NPI 1720786031 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities

Taxonomy Code261QM0855X

License✔ Licensed in AZ · OTC13694

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License LMFT15837 (AZ)

1102 E MISSOURI AVE, Phoenix, AZ 85014

Open in Google Maps ↗

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIELLE A HEYER

Counselor (Professional)