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LIBERTY ELLIS LLPC
NPI 1790302479
Counselor - Mental Health in Ypsilanti, MI

Active since June 29, 2020PECOS EnrolledAccepts Medicare Assignment
3150 PACKARD RD, YPSILANTI, MI 48197(734) 203-0183 Get Directions Write a Review

NPPES record last updated: June 29, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Liberty Ellis Llpc NPPES

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

LIBERTY ELLIS LLPC (NPI 1790302479) is an individual mental health provider in Ypsilanti, Michigan, licensed in Michigan (6401018389) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1790302479
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameLIBERTY ELLISCredential: LLPC
Location Address3150 PACKARD RDYpsilanti, MI 48197-1994
Mailing Address121 Perrin St Apt 2Ypsilanti, MI 48197-2641
Phone(734) 203-0183
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJune 29, 2020
NPPES CertifiedJune 29, 2020
✔ NPI 1790302479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MI · 6401018389
3150 PACKARD RD, Ypsilanti, MI 48197
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Liberty Ellis Llpc 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 ID42702649
PECOS Enrollment IDI20251121000844
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 Billing Reassignment

Medicare enrollment records show Liberty Ellis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mood Clinical, P. C.
1,942 mi
Family
980 W 17TH ST STE C
Santa Ana, CA 92706
  • Reassigned Medicare billing, California enrollment
  • 182 clinicians in this Medicare group
NPI 1922675644 (619) 639-9730

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 12

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

VITALIS IM
Social Worker (Clinical)
3150 PACKARD RD
YPSILANTI, MI 48197
Washtenaw County (248) 581-8777
DR. SHI-YU TAN MD
General Practice
3150 PACKARD RD
YPSILANTI, MI 48197
Washtenaw County (734) 276-7096
ANGELA MASINDE MA, LLPC, ATR-P
Counselor (Professional)
3150 PACKARD RD
YPSILANTI, MI 48197
Washtenaw County (734) 203-0183
LINCOLN HOME HEALTH SERVICES, LLC
Home Health
3150 PACKARD RD
YPSILANTI, MI 48197
Washtenaw County (313) 415-0058
MS. STACEY MICHELLE MACK MSW
Social Worker (Clinical)
3150 PACKARD RD
YPSILANTI, MI 48197
Washtenaw County (734) 879-0162
JENNIFER BLOUGH LLPC
Counselor (Professional)
3150 PACKARD RD
YPSILANTI, MI 48197
Washtenaw County (734) 203-0183
DEEPWATER COUNSELING, PLLC
Counselor (Professional)
3150 PACKARD RD
YPSILANTI, MI 48197
Washtenaw County (734) 203-0183
AMBER NICOLE HUGHSON LLMSW
Social Worker (Clinical)
3150 PACKARD RD
YPSILANTI, MI 48197
Washtenaw County (248) 581-8777

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 Liberty Ellis's NPI number?

The NPI number for Liberty Ellis is 1790302479. It was assigned to this individual provider in the NPPES registry on June 29, 2020.

Where is Liberty Ellis located?

Liberty Ellis practices at 3150 Packard Rd, Ypsilanti, MI 48197. The listed phone number is (734) 203-0183.

What is Liberty Ellis's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Liberty Ellis enrolled in Medicare?

Yes. Liberty 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.

Which organization bills Medicare for Liberty Ellis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Liberty Ellis reassigns Medicare benefits to Mood Clinical, P. C. (Santa Ana, CA). 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 Liberty 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 Liberty Ellis was last updated on June 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.