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General NPI Number Information
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NPI Number | 1710974035
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Entity Type | Organization
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Legal Business Name | ELLIOTT & ASSOCIATES INC
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 5600 MONROE ST STE 201A
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City | SYLVANIA
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State | OH
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Zip | 43560-2775
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Country | US
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Telephone | 419-885-1910
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Fax | 419-885-5060
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Provider Business Mailing Address
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Address Line | 5600 MONROE ST STE 201A
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City | SYLVANIA
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State | OH
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Zip | 43560-2775
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Country | US
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Telephone | 419-885-1910
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Fax | 419-885-5060
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST/OWNER
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Name | DR. JACOB J ELLIOTT
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Credential | PHD
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Telephone | 419-885-1910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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