Ellis, Vickie R
Ellis, Vickie R is an individual health care provider with primary practice located at Fort George G. Meade, Meddac Headquarters 2480 Llewellyn Ave., Ste 5800, Ft. Meade MD 20755-5129. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ellis, Vickie R can be contacted via phone (301) 677-8798.Contact Information
Primary practice address
Fort George G. Meade, Meddac Headquarters 2480 Llewellyn Ave., Ste 5800
Ft. Meade MD 20755-5129
Phone: (301) 677-8798
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 0904007011 |
Profile Details
| NPI number | 1104069061 |
|---|---|
| LBN Legal business name | Ellis, Vickie R |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 8th, 2009 |
| Last updated | Jan 4th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104069061 | NPPES |
| Virginia | MEDICAID | 49-45573 |
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