Organization
ELLA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETITIA VIDETTE BECKETT-HAYWOOD LCSW (PRESIDENT)
(317) 460-1312
Entity
Organization
Contact information
Practice address
2511 E 46TH ST, SUITE N4, INDIANAPOLIS, IN 46205-2460
(317) 542-1473
(317) 542-1602
Mailing address
2511 E 46TH ST, SUITE N4, INDIANAPOLIS, IN 46205-2460
(317) 542-1473
(317) 542-1602
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005683A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200936060A
—
IN
Enumeration date
06/09/2010
Last updated
06/09/2010
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