ANNA ELLIS (MA, LADC, LPCC) – Mental Health Counselor, NPI 1679232136

ANNA ELLIS (MA, LADC, LPCC) is a healthcare provider. based in Minneapolis, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA, LADC, LPCC. They hold a License No. 305435 (MN). The NPI Number for ANNA ELLIS (MA, LADC, LPCC) is 1679232136

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
ANNA ELLIS (MA, LADC, LPCC)
NPI
1679232136
Phone
Not provided
Address
1404 CENTRAL AVE NE
Enumeration Date
13 December 2021
Last Update Date
31 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7634829598
Graduation Year
2019 (7 years ago)
PAC ID
1052756723
Group Practice PAC ID
0941661482
Professional Enrollment ID
I20240304003508
Address ID
MN553044259AN1875XNWXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:4State licenses:2Digital endpointsOther names

1,813 MENTAL HEALTH COUNSELOR in MN

Provider Addresses for ANNA ELLIS (MA, LADC, LPCC)

  • 1404 CENTRAL AVE NE

    MINNEAPOLIS, MN 554131517

    Phone:

    Type: Mailing

  • 18205 45TH AVE N STE D

    PLYMOUTH, MN 554464594

    Phone:

    Type: Mailing

  • 1875 STATION PKWY NW

    ANDOVER, MN 553043319

    Phone: (763) 482-9598

    Type: Location

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: 2024-03-04

PECOS data refreshed: 2026-05-27

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
I20240304003508IMental Health CounselorMNTBD

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 55413)

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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: 0941661482View full group profile
NameSpecialtyState
Mental Health CounselorNE
Clinical Social WorkerMN
Clinical Social WorkerMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
Mental Health CounselorMN
Mental Health CounselorMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

How do payers reference ANNA ELLIS (MA, LADC, LPCC)?
For ANNA ELLIS (MA, LADC, LPCC), use NPI 1679232136 as the unique 10-digit identifier.
Would ANNA ELLIS (MA, LADC, LPCC) appear as active to a payer?
You can treat ANNA ELLIS (MA, LADC, LPCC) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with ANNA ELLIS (MA, LADC, LPCC)?
ANNA ELLIS (MA, LADC, LPCC)'s record emphasizes Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Is ANNA ELLIS (MA, LADC, LPCC) associated with Minneapolis?
Public fields place ANNA ELLIS (MA, LADC, LPCC) around Minneapolis, Minnesota. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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