MEDICARE: ELLEN KUBAY ADKINS

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
1	1041C0700X	Clinical Social Worker
2	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1740339845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELLEN KUBAY ADKINS

Provider Business Mailing Address
First Line	:	77 W ELMWOOD DR
Second Line	:	116
City	:	CENTERVILLE FINANCE
State	:	OH
Zip	:	45459-4239
Country	:	US
Telephone Number	:	937-433-4430
Fax Number	:

Provider Business Practice Location Address
First Line	:	77 W ELMWOOD DR
Second Line	:	116
City	:	CENTERVILLE FINANCE
State	:	OH
Zip	:	45459-4239
Country	:	US
Telephone Number	:	937-433-4430
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ELLEN KUBAY ADKINS
Credential	:
Telephone Number	:	937-433-4430

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	09/11/2025

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