Ellen Homlong, PC, RD,LD,CDE

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C.1300021 Issued in OH

Practice address

4641 Fulton Dr NW
Canton, OH 44718-2384

Phone

(330) 433-6075

NPI assigned

Jan 29, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cfpa LLC

  • Psychologist
  • Cuyahoga Falls, OH
  • NPI 1780987461
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386201600000",
    "number": "1063558294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 HARLAND DR",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442363257",
            "telephone_number": "234-380-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182384",
            "telephone_number": "330-433-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMLONG",
        "first_name": "ELLEN",
        "credential": "PC, RD,LD,CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2013-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD4671",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.1300021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063558294",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Todd Harold Holt, RN
• John Eric Holton
• Home Health Care by Callos LLC
• Home Health Ohio LLC
• Home Preferred Home Care, LTD.
• Catherine Elizabeth Hommer, LPC
• Honesty and Persistent Development LLC
• Caroline Hong, DDS
• Gloria Jacqueline Hong, MD
• Katie Lynn Hood, APRN

• Professional Counselor in Canton, OH
• Providers in Canton, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.