ELIZABETH LAURIE ELLISON (MS LMFT) – Marriage & Family Therapist, NPI 1104101245

ELIZABETH LAURIE ELLISON (MS LMFT) is a healthcare provider. based in Madison, Wisconsin. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials MS LMFT. They hold a License No. 970-124 (WI). The NPI Number for ELIZABETH LAURIE ELLISON (MS LMFT) is 1104101245

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
ELIZABETH LAURIE ELLISON (MS LMFT)
NPI
1104101245
Phone
(608) 358-5111
Address
25 KESSEL CT STE 105
Enumeration Date
20 October 2011
Last Update Date
21 December 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6082802700
Graduation Year
2010 (16 years ago)
PAC ID
3375087935
Group Practice PAC ID
6406844661
Professional Enrollment ID
I20240708000558
Address ID
WI537116200MA49XXXCTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

243 MARRIAGE AND FAMILY THERAPIST in WI

Provider Addresses for ELIZABETH LAURIE ELLISON (MS LMFT)

  • 25 KESSEL CT STE 105

    MADISON, WI 537116227

    Phone: (608) 358-5111

    Type: Mailing

  • 1320 MENDOTA ST STE 120

    MADISON, WI 537141060

    Phone: (608) 280-3106

    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: 2024-07-08

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
I20240708000558IMarriage And Family TherapistWITBD

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 53711)

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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: 6406844661View full group profile
NameSpecialtyState
-WI
Nurse PractitionerWI
Clinical Social WorkerWI
Mental Health CounselorWI
Clinical Social WorkerWI
Mental Health CounselorWI
Physician AssistantWI
Clinical Social WorkerWI
Mental Health CounselorWI
-WI

Reviews

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Frequently asked questions

Where can patients find ELIZABETH LAURIE ELLISON (MS LMFT)'s NPI?
You can confirm ELIZABETH LAURIE ELLISON (MS LMFT) with NPI 1104101245; it appears in the national provider directory.
Is ELIZABETH LAURIE ELLISON (MS LMFT) active in the national directory?
ELIZABETH LAURIE ELLISON (MS LMFT)'s public NPI profile is in an active state.
What field does ELIZABETH LAURIE ELLISON (MS LMFT) work in?
You can think of ELIZABETH LAURIE ELLISON (MS LMFT) as practicing within Marriage & Family Therapist. Clinical services aligned with this taxonomy classification.
Where is ELIZABETH LAURIE ELLISON (MS LMFT)'s primary listing?
We display Madison, Wisconsin because that is what the record indicates for ELIZABETH LAURIE ELLISON (MS LMFT).
Is ELIZABETH LAURIE ELLISON (MS LMFT) a real provider?
This page reflects official NPPES data for NPI 1104101245. Always confirm identity and privileges with the practice and licensing boards.

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