Ellis, Jessica

Ellis, Jessica is an sole proprietor health care provider with primary practice located at 2132 S 12Th St Ste 103 , Allentown PA 18103-4814. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Ellis, Jessica can be contacted via phone (484) 359-3447.

Contact Information

Primary practice address
2132 S 12Th St Ste 103 Allentown PA 18103-4814
Phone: (484) 359-3447
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X PC009799 Pennsylvania

Profile Details

NPI number 1851775704
LBN Legal business name Ellis, Jessica
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 9th, 2015
Last updated Sep 25th, 2020 - about 6 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 1851775704 NPPES
Pennsylvania MEDICAID 1851775704

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