Individual
MS. LINDA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC1578
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033901
VALUE OPTIONS
—
01
—
52492483-001
BLUECROSS/BLUE SHIELD
GA
Enumeration date
04/14/2006
Last updated
01/06/2014
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