Ellie Blair
Individual provider Active NPI Counselor · Charlestown, IN
NPI 1780439935 · NPPES record last updated Apr 22, 2024
Key facts
- NPI
- 1780439935
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 7509 Charlestown Pike
Charlestown, IN 47111-9623 - Phone
- (812) 256-4686
- NPI assigned
- Apr 22, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
7509 Charlestown Pike
Charlestown, IN 47111-9623
Mailing address
7509 Charlestown Pike
Charlestown, IN 47111-9623
Phone (812) 256-4686
Other providers in Charlestown, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2024. 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.