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Individual
MRS. LILA ELIZABETH ELLISON
Active
Individual
MRS. LILA ELIZABETH ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C002603
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
147AP
BCBS-NC
NC
01
—
408630
MHN
NC
05
—
6005172
—
NC
01
—
FH5000450
FIRST CAROLINA CARE
—
Enumeration date
02/13/2007
Last updated
04/25/2008
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