Individual
MS. REBECCA LEE ELLISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LCADC
Contact information
Practice address
525 W 5TH ST STE 219, COVINGTON, KY 41011-1293
(859) 292-4144
Mailing address
525 W 5TH ST STE 219, COVINGTON, KY 41011-1293
(859) 292-4144
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
243469
KY
1041C0700X
Clinical Social Worker
Primary
127570
CA
1041C0700X
Clinical Social Worker
253581
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100567210
—
KY
Enumeration date
10/31/2018
Last updated
05/27/2025
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