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General NPI Number Information
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NPI Number | 1861987372
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Entity Type | Individual
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Provider Name | ELLEN L DAVIS LPCC
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Gender | Female
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 135 PINELAWN RD STE 204N
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City | MELVILLE
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State | NY
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Zip | 11747-3133
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Country | US
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Telephone | 646-687-4646
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Fax | 844-222-4005
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Provider Business Mailing Address
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Address Line | 159 COTTAGE LN
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-3716
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Country | US
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Telephone | 740-703-1749
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | E.2202896
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License Number State | OH
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