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Organization

LINDA ELLIS, MA, LPC

Active
Other names
Linda Ellis, MA, LPC, INC
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LINDA ELLIS LPC (LICENSED COUNSELOR)
(706) 781-2661
Entity
Organization

Contact information

Practice address
48 HARALSON PL, SUITE 3, BLAIRSVILLE, GA 30512-3087
(706) 781-2661
(706) 781-2661
Mailing address
255 STABLE GATE DR, BLAIRSVILLE, GA 30512-8062
(706) 781-2661
(706) 781-2661

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1578
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
033901
VALUE OPTIONS
01
084833
MHN
01
1151965
CAQH
01
289514654
UNITED BEHAVIORAL HEALTH
01
52492483-001
BCBSGA
GA
01
6838713
CIGNA
05
694416721-A
GA
01
731631000
MAGELLAN
Enumeration date
01/07/2014
Last updated
01/07/2014
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