Healthcare Provider Details

I. General information

NPI: 1417248972
Provider Name (Legal Business Name): ELLEN IRENE HARRINGTON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 05/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

898 E MAIN ST
GREENWOOD IN
46143-1407
US

IV. Provider business mailing address

898 E MAIN ST
GREENWOOD IN
46143-1407
US

V. Phone/Fax

Practice location:
  • Phone: 317-887-1348
  • Fax: 317-859-4320
Mailing address:
  • Phone: 317-887-1348
  • Fax: 317-859-4320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39002088A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: