GENEVIEVE BRIENNE ELLIS (LPC) – Professional Counselor, NPI 1104537380

GENEVIEVE BRIENNE ELLIS (LPC) is a healthcare provider. based in Woodstock, Georgia. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. LPC014369 (GA). The NPI Number for GENEVIEVE BRIENNE ELLIS (LPC) is 1104537380

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
GENEVIEVE BRIENNE ELLIS (LPC)
NPI
1104537380
Phone
(470) 552-8470
Address
100 STONEFOREST DR STE 230
Enumeration Date
8 December 2022
Last Update Date
8 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4705528470
Graduation Year
2020 (6 years ago)
PAC ID
6002251170
Group Practice PAC ID
5092611384
Professional Enrollment ID
I20240228002200
Address ID
GA301894903WO100XXDRXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

1,201 MENTAL HEALTH COUNSELOR in GA

Provider Addresses for GENEVIEVE BRIENNE ELLIS (LPC)

  • 100 STONEFOREST DR STE 230

    WOODSTOCK, GA 301894903

    Phone: (470) 552-8470

    Fax: (470) 437-3924

    Type: Location

  • 4800 N SCOTTSDALE RD STE 2500

    SCOTTSDALE, AZ 852517630

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-28

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240228002200IMental Health CounselorGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30189)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5092611384View full group profile
NameSpecialtyState
Nurse PractitionerGA
-GA
-GA
Clinical PsychologistGA
Nurse PractitionerGA
Clinical PsychologistGA
P S Y C H I A T R YGA
Mental Health CounselorTN
Clinical PsychologistGA
Nurse PractitionerGA

Reviews

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Frequently asked questions

Is GENEVIEVE BRIENNE ELLIS (LPC) listed with a National Provider Identifier?
Yes — GENEVIEVE BRIENNE ELLIS (LPC) has NPI 1104537380 on file in the registry.
Is there an active status for GENEVIEVE BRIENNE ELLIS (LPC)?
For scheduling context, GENEVIEVE BRIENNE ELLIS (LPC) is shown as active in the registry.
What expertise is attributed to GENEVIEVE BRIENNE ELLIS (LPC)?
GENEVIEVE BRIENNE ELLIS (LPC)'s specialty line reads Professional Counselor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for GENEVIEVE BRIENNE ELLIS (LPC)?
Travel planning: use Woodstock, Georgia as the reference point for GENEVIEVE BRIENNE ELLIS (LPC), then confirm.
When was this NPI issued?
Enumeration for GENEVIEVE BRIENNE ELLIS (LPC) is noted as December 8, 2022 where the registry provides it.

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