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NPI Code Detail

MEDICARE: CHRISTY ELLIS LCSWA

MEDICARE: CHRISTY ELLIS LCSWA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerP008454NC

General Provider Information

NPI Number : 1124456793
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTY ELLIS LCSWA
Provider Business Mailing Address
First Line : 3000 HIGHWOODS BLVD STE 310
Second Line :
City : RALEIGH
State : NC
Zip : 27604-1029
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3000 HIGHWOODS BLVD STE 310
Second Line :
City : RALEIGH
State : NC
Zip : 27604-1029
Country : US
Telephone Number : 919-714-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2013
Last Update Date : 10/17/2013

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Directions to “ CHRISTY ELLIS LCSWA” Practice Location

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