Larry D. Ellis
Individual provider Active NPI Mental Health Counselor · Corinth, MS
NPI 1124499405 · NPPES record last updated Oct 13, 2015
Key facts
- NPI
- 1124499405
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 2664 S Harper Rd
Corinth, MS 38834-6723 - Phone
- (662) 287-4055
- NPI assigned
- Oct 13, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
2664 S Harper Rd
Corinth, MS 38834-6723
Mailing address
20 Deer Trail Rd
Selmer, TN 38375-6695
Phone (931) 209-0619
Other providers in Corinth, MS
- Tara Edmond
- Rhiannon Edmondson
- James D. Edmonson
- Chris Elliott
- David Matthew Ellis
- Besseri Emmanuel Christian Ako
- Empowering Wellness
- Jennifer April Ernst
- Anna K Erwin
- Brad Essary
All providers in Corinth, MS · Mental Health Counselor in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.