Ian Elliott, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

167289 Issued in OH

Practice address

2801 C CT
Ashtabula, OH 44004-4577

Phone

(440) 998-0722

NPI assigned

Jun 22, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Impact Recovery Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Andover, OH
  • NPI 1982535357
  NPD Authorized official
• Impact Recovery Services

  • Substance Abuse Rehabilitation Facility
  • Andover, OH
  • NPI 1306613823
  NPD

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1447745435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 C CT",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044577",
            "telephone_number": "440-998-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 C CT",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044577",
            "telephone_number": "440-998-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "IAN",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "167289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samar Said El Sayegh, MD
• Justin L Eldridge, LPTA
• Robert Elford
• Elizabeth Kuson Lisw-S, LLC
• Lynn Ellefsen, COTA
• Kevin Dayton Ellis, LICDC
• Shelly Emmett
• Karen Ensell, R.N.
• Tim Erickson
• Erie Vamc

• Addiction (Substance Use Disorder) Counselor in Ashtabula, OH
• Providers in Ashtabula, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.