Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carly Ellison, PMHNP-BC

Individual provider Family Nurse Practitioner · NPI 1508245028

Carly Ellison, PMHNP-BC is a Nurse Practitioner in Denver, Colorado. Qualified in 2021, 5 years ago. Practices with Revitalize Psychiatric Services Inc, a 4-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Colorado and Illinois.

Years since qualifying
5
Licensed in
CO, IL
In the registry since
2015
Specialties on file
3
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

7900 E Union Ave Ste 1100
Denver, CO 80237-2746
Phone: (303) 414-1164
Fax: (813) 906-7789
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 — (217) 698-9722

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence C-APN.0003842-C-NP (CO)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 209012884 (IL)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence 209012884 (IL)

Record details

NPI number1508245028
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorNo
NPI enumeratedMay 29, 2015
Last updated in NPPESApril 30, 2025
Certification dateApril 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Revitalize Psychiatric Services Inc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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