Organization
LINDA ELLIS, MA, LPC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA ELLIS MA (LICENSED PROFESSIONAL COUNSELOR)
(706) 781-2661
Entity
Organization
Contact information
Practice address
48 HARALSON PL, # 3, BLAIRSVILLE, GA 30512-3087
(706) 781-2661
(706) 781-2661
Mailing address
255 STABLE GATE DR, BLAIRSVILLE, GA 30512-8062
(706) 781-2661
(706) 781-2661
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC 1578
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326002379
INDIVIDUAL NPI
—
05
—
694416721A
—
GA
Enumeration date
03/09/2007
Last updated
12/17/2013
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