| Lisa B Ellis, Llc | |
|
1400 Buford Hwy Ste G7 Sugarhill GA 30518-8721 | |
| (404) 401-7715 | |
| (770) 995-1959 |
| Full Name | Lisa B Ellis, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1400 Buford Hwy, Sugarhill, Georgia |
| Authorized Official Name and Position | Lisa B Ellis (OWNER) |
| Authorized Official Contact | 4044017715 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa B Ellis, Llc 3635 Thompson Mill Rd Buford GA 30519-5448 Ph: (404) 401-7715 | Lisa B Ellis, Llc 1400 Buford Hwy Ste G7 Sugarhill GA 30518-8721 Ph: (404) 401-7715 |
| NPI Number | 1609206507 |
|---|---|
| Provider Enumeration Date | 11/14/2013 |
| Last Update Date | 08/17/2022 |
| Certification Date | 08/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609206507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW002706 (Georgia) | Primary |