Ellis, Kevin Dayton

Ellis, Kevin Dayton is an individual health care provider with primary practice located at 2801 C Ct , Ashtabula OH 44004-4577. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Ellis, Kevin Dayton can be contacted via phone (440) 998-0722.

Contact Information

Primary practice address
2801 C Ct Ashtabula OH 44004-4577
Phone: (440) 998-0722
Fax: (440) 992-1699
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 161600 Ohio

Profile Details

NPI number 1598272437
LBN Legal business name Ellis, Kevin Dayton
Credentials LICDC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 31st, 2017
Last updated Dec 31st, 2017 - about 9 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 1598272437 NPPES
Ohio Other 161600 OHIO CHEMICAL DEPENDENCY PROFESSIONALS BOARD

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