Individual provider · Type 1 NPI
Raven Keturah Ellis, LCPC
Professional Counselor · Randallstown, MD
NPI number
1003909664
Active
Practice location
3525 Resource Drive Room C47
Randallstown, MD 21133
Fax (410) 655-3941
Mailing address
10400 Ridgeland Road Ste 1
Cockeysville, MD 21030
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | LC1921 (MD) |
Professional Counselor: Definition to come...
2 other providers at this address
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About NPI 1003909664
Raven Keturah Ellis, LCPC's National Provider Identifier is 1003909664, issued on Oct 2, 2006. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Randallstown, MD. The record was last updated on Jul 8, 2007.