Healthcare Provider Details

I. General information

NPI: 1356056659
Provider Name (Legal Business Name): HANNAH ELLIS LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2023
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 N RICE ST
BREVARD NC
28712-3431
US

IV. Provider business mailing address

41 AIKEN ST
BREVARD NC
28712-4833
US

V. Phone/Fax

Practice location:
  • Phone: 828-513-0653
  • Fax: 828-372-4501
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HANNAH ELLIS
Title or Position: LCSW
Credential: LCSW
Phone: 828-513-0653