| Vanessa Ellison, Lcsw, Llc | |
|
11418 Crawford Wood Ter Midlothian VA 23114-5137 | |
| (804) 876-0407 | |
| Not Available |
| Full Name | Vanessa Ellison, Lcsw, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11418 Crawford Wood Ter, Midlothian, Virginia |
| Authorized Official Name and Position | Vanessa Ellison (MANAGER) |
| Authorized Official Contact | 8048760407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vanessa Ellison, Lcsw, Llc 11418 Crawford Wood Ter Midlothian VA 23114-5137 Ph: (804) 876-0407 | Vanessa Ellison, Lcsw, Llc 11418 Crawford Wood Ter Midlothian VA 23114-5137 Ph: (804) 876-0407 |
| NPI Number | 1437744844 |
|---|---|
| Provider Enumeration Date | 03/08/2021 |
| Last Update Date | 04/20/2024 |
| Certification Date | 04/20/2024 |
| Medicare PECOS PAC ID | 6406243872 |
|---|---|
| Medicare Enrollment ID | O20220504000244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437744844 | NPI | - | NPPES |
| 1710495635 | Other | VA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Vanessa M Ellison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710495635 PECOS PAC ID: 8022354778 Enrollment ID: I20190116003437 |
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