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

Individual provider Counselor · NPI 1548505860

Deontrae Marquise Ellis, LICDC is a Counselor in Springfield, Ohio. Works from 2 locations. Licensed in Ohio.

Licensed in
OH
In the registry since
2012
Specialties on file
2
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Practice location Address checks out

201 N Yellow Springs St
Springfield, OH 45504-2650
Phone: (833) 510-4357
Fax: (513) 881-7188
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1830 W High St, Piqua, OH 45356-9399 — (833) 510-4357

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence LICDC.151072 (OH)
Counselor Taxonomy 101Y00000X

Record details

NPI number1548505860
Entity typeIndividual (Type 1)
GenderMale
Credentials LICDC
Sole proprietorNo
NPI enumeratedNovember 28, 2012
Last updated in NPPESOctober 24, 2023
Certification dateOctober 24, 2023

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