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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104069061 NPPES
Virginia MEDICAID 49-45573

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