Costello, Ellen M.

Costello, Ellen M. is an individual health care provider with primary practice located at 345 Blackstone Blvd , Providence RI 02906-4800. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Costello, Ellen M. can be contacted via phone (401) 455-6416.

Contact Information

Primary practice address
345 Blackstone Blvd Providence RI 02906-4800
Phone: (401) 455-6416
Fax: (401) 455-6293
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PS00412 Rhode Island

Profile Details

NPI number 1538252341
LBN Legal business name Costello, Ellen M.
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538252341 NPPES
Rhode Island Other 24002-0 BLUE CROSS
Rhode Island Other 406371 BLUE CROSS
Rhode Island Other 61-11464 BLUE CROSS

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