Individual
DEBORAH S ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1130 TEN ROD RD, SUITE D-104, NORTH KINGSTOWN, RI 02852-4161
(401) 295-5575
(401) 295-5552
Mailing address
1130 TEN ROD RD, SUITE D-104, NORTH KINGSTOWN, RI 02852-4161
(401) 258-7511
(401) 295-5575
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01473
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033160
BEACON HEALTH STRATEGIES
RI
01
—
21729-1
BLUE CROSS BLUE SHIELD OF
RI
01
—
410115
BLUE CHIP
RI
01
—
722607000
MAGELLAN
RI
Enumeration date
08/12/2006
Last updated
04/30/2018
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