Audrene Ellis, PHD
NPI 1366105207ActiveIndividual· Counselor, Professional· Little Rock, AR
Counselor, Professional (PHD) with Wellspring Renewal Center, practicing in Little Rock, Arkansas. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1366105207 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | Yes |
| NPI issued | Oct 18, 2021 |
| Last updated in NPPES | Jan 31, 2024 |
| Certified by provider | Jan 31, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | P2211007 | AR |
| Counselor | 101Y00000X | P2211007 | AR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (AR) |
|---|
Education and affiliations
| Graduation year | 2019 |
|---|---|
| Medicare specialty | Mental Health Counselor |
Medical group
- Wellspring Renewal CenterLittle Rock, AR · 6 clinicians
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