ANNE ELLINGSON PROVISIONAL
NPI 1841665668
Counselor - Addiction (Substance Use Disorder) in Jackson, WY

Active since December 04, 2015Opted out of Medicare · through Mar 5, 2028
610 W BROADWAY AVE, SUITE L1, JACKSON, WY 83001(307) 733-3908(307) 734-0017 Get Directions Write a Review

NPPES record last updated: December 4, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Anne Ellingson Provisional NPPES

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

ANNE ELLINGSON PROVISIONAL (NPI 1841665668) is an individual addiction (substance use disorder) provider in Jackson, Wyoming, licensed in Wyoming (PAT-073) and active in the NPI registry since December 2015. She has opted out of Medicare through March 5, 2028.

NPPES Registry Identity

NPI1841665668
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameANNE ELLINGSONCredential: PROVISIONAL
Location Address610 W BROADWAY AVE, SUITE L1Jackson, WY 83001-8213
Mailing AddressPo Box 11390Jackson, WY 83002-1390 · (307) 733-3908 · Fax (307) 734-0017
Fax(307) 734-0017
Sole ProprietorNo
Enumeration DateDecember 4, 2015
NPI 1841665668 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License Licensed in WY · PAT-073
610 W BROADWAY AVE, Jackson, WY 83001

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Anne Ellingson Provisional has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 5, 2026 through March 5, 2028.

Opt-Out Effective DateMarch 5, 2026
Opt-Out In Effect ThroughMarch 5, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 10

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

Internal Medicine
610 W BROADWAY AVE, SUITE 108
JACKSON, WY 83001
Social Worker (Clinical)
610 W BROADWAY AVE
JACKSON, WY 83001
Dentist
610 W BROADWAY AVE
JACKSON, WY 83001
Social Worker
610 W BROADWAY AVE, STE L1
JACKSON, WY 83001
Counselor (Addiction (Substance Use Disorder))
610 W BROADWAY AVE, STE L1
JACKSON, WY 83001
Marriage & Family Therapist
610 W BROADWAY AVE, 109
JACKSON, WY 83001
Social Worker (Clinical)
610 W BROADWAY AVE
JACKSON, WY 83001
Social Worker (Clinical)
610 W BROADWAY AVE
JACKSON, WY 83001

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 Anne Ellingson's NPI number?

The NPI number for Anne Ellingson is 1841665668. It was assigned to this individual provider in the NPPES registry on December 4, 2015.

Where is Anne Ellingson located?

Anne Ellingson practices at 610 W Broadway Ave Suite L1, Jackson, WY 83001. The listed phone number is (307) 733-3908.

What is Anne Ellingson's specialty?

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

Is Anne Ellingson enrolled in Medicare?

No. Anne Ellingson has opted out of Medicare through March 5, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Anne Ellingson accept?

Health plans from Blue Cross Blue Shield of Wyoming list Anne Ellingson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Anne Ellingson was last updated on December 4, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.