| Alice Ellis, Lpcc | |
|
3651 Shepherdsville Rd Elizabethtown KY 42701-9511 | |
| (270) 401-5450 | |
| (270) 360-0767 |
| Full Name | Alice Ellis, Lpcc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3651 Shepherdsville Rd, Elizabethtown, Kentucky |
| Authorized Official Name and Position | Alice A Ellis (AUTHORIZED AGENT) |
| Authorized Official Contact | 2704015450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alice Ellis, Lpcc 3651 Shepherdsville Rd Elizabethtown KY 42701-9511 Ph: (270) 401-5450 | Alice Ellis, Lpcc 3651 Shepherdsville Rd Elizabethtown KY 42701-9511 Ph: (270) 401-5450 |
| NPI Number | 1679941751 |
|---|---|
| Provider Enumeration Date | 09/08/2015 |
| Last Update Date | 09/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679941751 | NPI | - | NPPES |
| 7100355870 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPCPCC00216428 (Kentucky) | Primary |
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