ELLICE PARK (NPI# 1356891477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356891477 |
| Entity Type | Individual |
| Full Name | ELLICE PARK |
| Practice Address |
4449 Easton Way Ste 200 Columbus OH 43219 |
| Mailing Address |
20 S 3rd St Ste 210 Columbus OH 43215-4206 |
| Practice Telephone | 6145683233 |
| Mailing Telephone | 6145683233 |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2020-01-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 150556 | OH | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
150556 | OH | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
C.1500556 | OH | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
150556 | OH | Behavioral Health & Social Service Providers |
| N | 101YS0200X |
Counselor Specialization: School |
150556 | OH | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| N/A: NO IDENTIFICATION NUMBERS AVAILABLE | 000000000 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1375 Us Highway 42 Se Ste C, London, OH 431409548 | 7408458652 | 6145030899 |
| Street Address |
4449 EASTON WAY STE 200 |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811244833 | Columbus Addiction and Psychiatric Services LLC | Psychiatry & Neurology | 4449 Easton Way Ste 200, Columbus, OH 43219-6093 | 2012-08-08 |
| 1710527585 | Therapy Land, Ltd | Counselor | 4449 Easton Way Ste 200, Columbus, OH 43219-7005 | 2020-01-09 |
| 1255778502 | Premier Recovery Center, LLC | Psychiatry & Neurology | 4449 Easton Way Ste 200, Columbus, OH 43219-6093 | 2013-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003430844 | Pdq Transportation Inc | Secured Medical Transport (VAN) | 1640 E 5th Ave, Columbus, OH 43219 | 2020-06-06 |
| 1366066599 | Urban Limousine LLC | Secured Medical Transport (VAN) | 1640 E. 5th Ave, Columbus, OH 43219 | 2020-06-03 |
| 1841757879 | Camille Cook | Nurse Practitioner | 4200 Regent St. Suite 200, Columbus, OH 43219 | 2019-02-26 |
| 1164904595 | Vida Yeboah | Registered Nurse | 2320 Doneen Dr, Columbus, OH 43219 | 2018-09-01 |
| 1407373129 | Chevon Marie Wiseman | Nurse's Aide | 2835 Jared Pl, Columbus, OH 43219 | 2017-08-23 |
| 1952826737 | Hilary Schadle Demostenes | Social Worker | 2780 Airport Dr, Suite 100 - Billing/credentialing Dept., Columbus, OH 43219 | 2017-08-14 |
| 1851833800 | Amanda Yahn | Student in an Organized Health Care Education/Training Program | 2469 Stelzer Road, Bradford School, Columbus, OH 43219 | 2016-11-08 |
| 1215312939 | Taylor Weary | Student in an Organized Health Care Education/Training Program | 2649 Stelzer Rd, Columbus, OH 43219 | 2015-07-23 |
| 1568846715 | Brenton Semplak | Student in an Organized Health Care Education/Training Program | 2469 Stelzer Rd., Columbus, OH 43219 | 2015-07-17 |
| 1811384746 | Visionworks, Inc | Eyewear Supplier (Equipment, not the service) | 4142 Seward Street, Suite F105, Columbus, OH 43219 | 2015-04-17 |
| Find all providers in zip 43219 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609481233 | Dupe Esther Oluwamuyide | Counselor | 1558 Sargas St, Columbus, OH 43240-6071 | 2020-09-10 |
| 1346851086 | Jeannine Marie Lumpkin | Counselor | 5065 Pond View Dr, Columbus, GA 31907-1887 | 2020-08-16 |
| 1174141543 | Emanuel G Werner | Counselor | 4033 Legend, Columbus, OH 43230-8501 | 2020-07-11 |
| 1285256552 | Lauren Elizabeth Singleton | Counselor | 5632 Winvelly Dr, Columbus, GA 31909-4777 | 2020-05-10 |
| 1265053268 | Bradley Unruh | Counselor | 1290 Old Henderson Rd, Columbus, OH 43220-3608 | 2020-04-30 |
| 1073153904 | Overbrook Counseling LLC | Counselor | 1161 Bethel Rd Ofc 5, Columbus, OH 43220-2773 | 2020-01-08 |
| 1871137497 | Tammy Dionne Person | Counselor | 6718 Bridge Way, Columbus, GA 31904-1370 | 2019-11-06 |
| 1740836659 | Allen Huff | Counselor | 223 Mayfair Blvd Apt D, Columbus, OH 43213-2212 | 2019-08-15 |
| 1780236224 | Emilie Rae Rogers | Counselor | 94 Northwoods Blvd Ste B2, Columbus, OH 43235-4721 | 2019-07-15 |
| 1649834441 | Stacey R Young | Counselor | 1620 E Broad St Ste 103, Columbus, OH 43203-2012 | 2019-04-26 |
| Find all providers in COLUMBUS | ||||
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| 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.