NICOLE RENEE ELLIS (NPI# 1164580106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164580106 |
| Entity Type | Individual |
| Full Name | NICOLE RENEE ELLIS |
| Credential | LPCC-S, NCC |
| Practice Address |
108 Christine Way Elizabethtown KY 42701-9681 |
| Mailing Address |
108 Christine Way Elizabethtown KY 42701 |
| Practice Telephone | 2703122877 |
| Mailing Telephone | (270) 312-2877 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
KY-1064 | KY | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
KY-0442 | KY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 30605018 | 05 | |
| KY | ANTHEM | 000000498778 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1072 S Dixie Blvd, Radcliff, KY 401601103 | 2703518166 | 2703518322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053633669 | Nicole Ellis | Counselor | 1951 Alamanda Ct, Navarre, FL 32566-7658 | 2010-02-23 |
| 1679707871 | Nicole Alexandria Ellis | Acupuncturist | 2809 Rockefeller Ave Ste A, Everett, WA 98201-3541 | 2009-05-04 |
| 1568078665 | Nicole C Ellis | Behavior Technician | 225 Cedar Hill St Ste 200, Marlborough, MA 01752-5900 | 2020-09-23 |
| 1013548478 | Nicole Ellis | Occupational Therapy Assistant | 2868 Beltagh Avenue, Bellmore, NY 11710 | 2020-02-03 |
| 1720632995 | Nicole Ellis | Speech-Language Pathologist | 11030 Raven Ridge Rd Ste 101, Raleigh, NC 27614-8512 | 2019-07-26 |
| 1023467966 | Nicole Ellis | Counselor | 2275 Arlington Dr, San Leandro, CA 94578-1132 | 2016-06-10 |
| 1710335237 | Nicole Grace Ellis | Physical Therapist | 7055 High Grove Blvd, Burr Ridge, IL 60527-7628 | 2016-05-25 |
| 1467850453 | Nicole Ellis | Case Management | 1330 N Classen Blvd, Suite 302, Oklahoma City, OK 73106-6835 | 2014-12-08 |
| 1861812877 | Nicole Ellis | Counselor | 545 Laurel St, San Diego, CA 92101-1634 | 2014-04-17 |
| 1134443120 | Nicole Anne Ellis | Speech-Language Pathologist | 105 Victory Rd, Dorchester, MA 02122-3518 | 2010-03-18 |
| Street Address |
108 CHRISTINE WAY |
| City | ELIZABETHTOWN |
| State | KY |
| Zip Code | 42701-9681 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693104 | James G. Thornton | Specialist/Technologist, Other | 2409 Ring Road, Suite 106, Elizabethtown, KY 42701 | 2020-09-11 |
| 1033720727 | Rebecca Williams | Pharmacist | 1602 N Dixie Highway, Elizabethtown, KY 42701 | 2020-08-14 |
| 1245855709 | Mckenzie Jo Clemons | Speech-Language Pathologist | 107 Financial Drive, Elizabethtown, KY 42701 | 2020-06-10 |
| 1215565825 | Christina Nichole Hobson | Peer Specialist | 413 E Dixie Ste 106, Elizabethtown, KY 42701 | 2020-03-30 |
| 1336701275 | Cassandra Elizabeth Baker | Nurse Practitioner | 2005 N. Dixie Highway, Elizabethtown, KY 42701 | 2019-07-01 |
| 1487134276 | Ryan Leon Hogan | Marriage & Family Therapist | 1106 Tunnel Hill Road, Suite 100, Elizabethtown, KY 42701 | 2018-08-21 |
| 1033623921 | Kayla Russell | Behavior Technician | 529 Westport Road, Elizabethtown, KY 42701 | 2017-11-30 |
| 1578087128 | Brenda Gale Nunn | Case Manager/Care Coordinator | 2600 Ring Road, Elizabethtown, KY 42701 | 2017-07-26 |
| 1013451277 | Chelsea Danielle Thorn | Nurse Practitioner | 2005 N. Dixie Hwy, Elizabethtown, KY 42701 | 2016-12-07 |
| 1003364597 | Joseph Michael Senay | Pharmacist | 521 Robinbrooke Dr., Cancer Care Center of Hardin Memorial Hospital, Elizabethtown, KY 42701 | 2016-09-14 |
| Find all providers in zip 42701 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265041115 | Tamathy Henderson | Counselor | 129b Howell Dr, Elizabethtown, KY 42701-3614 | 2020-07-27 |
| 1326673526 | Natasha Regina Porter | Counselor | 120 Meena Way Apt 3a, Elizabethtown, KY 42701-4826 | 2020-03-08 |
| 1295236149 | Tiffany Bufort | Counselor | 1890 N Market St, Elizabethtown, PA 17022-1131 | 2018-02-26 |
| 1356791750 | Brandy Heavrin | Counselor | 1106 Tunnel Hill Rd # 100, Elizabethtown, KY 42701-8067 | 2016-06-16 |
| 1023463254 | Michelle Marie Davy | Counselor | 40 W Hummelstown St, Elizabethtown, PA 17022-2021 | 2016-04-25 |
| 1235595901 | Terri Dugan | Counselor | 790 N Dixie Ave Ste B100, Elizabethtown, KY 42701-2488 | 2016-01-11 |
| 1770979379 | Erika Del Carmen Matzdorff | Counselor | 202 N Mulberry St, Elizabethtown, KY 42701-1441 | 2015-04-09 |
| 1427447473 | Charlotte Campbell Davis | Counselor | 1111 N Dixie Hwy Ste 2, Elizabethtown, KY 42701-2764 | 2015-01-14 |
| 1528475670 | Stephanie Bridgehouse | Counselor | 978 Milton Grove Rd N, Elizabethtown, PA 17022-8485 | 2014-07-21 |
| 1336470673 | Holly B Daknis | Counselor | 1311 N Dixie Hwy Bldg D, Elizabethtown, KY 42701-2621 | 2010-01-27 |
| Find all providers in ELIZABETHTOWN | ||||
| City | ELIZABETHTOWN |
| Zip Code | 42701 |
Please comment or provide details below to improve the information on NICOLE RENEE ELLIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.