Individual
ROXANNE ROST ELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
402 TRENT DRIVE, DURHAM, NC 27705
(919) 668-5559
(919) 668-4496
Mailing address
PO BOX 2906, DURHAM, NC 27710
(919) 668-4498
(919) 668-4496
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
339
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111771
—
NC
Enumeration date
08/25/2006
Last updated
07/08/2007
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