Khalihah Ellis, CSW
Individual provider Active NPI Case Manager/Care Coordinator · Grenada, MS
NPI 1124526322 · NPPES record last updated Sep 17, 2018
Key facts
- NPI
- 1124526322
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 980 Fairwood Dr
Grenada, MS 38901-3609 - Phone
- (662) 230-2144
- NPI assigned
- Jan 23, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
980 Fairwood Dr
Grenada, MS 38901-3609
Mailing address
980 Fairwood Dr
Grenada, MS 38901-3609
Phone (662) 230-2144
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1108804 | Medicaid | LA |
Other providers in Grenada, MS
- Keshia Dukes
- E L Transit Solutions LLC
- Benjamin Clayton Edwards
- Misty Edwards
- Elite Performance Physical Therapy
- Tiffany Elmore
- Encore Rehabilitation Inc
- Catiecha L Eskridge
- Evolution Clinical Counseling and Services
- Family Cancer Center, PLLC
All providers in Grenada, MS · Case Manager/Care Coordinator in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2018. 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.