person
Raven Keturah Ellis, LCPC
Professional Counselor in Randallstown, Maryland
NPI 1003909664

Raven Keturah Ellis is a Professional Counselor based in Cockeysville, MD and is specialized in Professional. Raven Keturah Ellis practices in Randallstown, MD and has the professional credentials of LCPC. The NPI Number for Raven Keturah Ellis is 1003909664 and holds a License No. LC1921 (Maryland).

The current practice location address for Raven Keturah Ellis is 3525 Resource Drive Room C47, Randallstown, MD and can be reached out via phone at 410-655-7655 and via fax at 410-655-3941.

Location: 3525 Resource Drive Room C47, Randallstown, MD, 21030
person
Provider Profile Details
NPI Number
1003909664
Provider Name
Raven Keturah Ellis
Credential
LCPC
Provider Entity Type
Individual
Gender
Female
Address
3525 Resource Drive Room C47, Randallstown, MD, 21030
Phone Number
410-655-7655
Fax Number
410-655-3941
Provider Enumeration Date
10/02/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
251690 01 COMPSYCH
64558301 01 CAREFIRST MD
R5830050 01 CAREFIRST EHMSI
institution
Provider Business Practice Location Address Details
Address
3525 Resource Drive Room C47
City
State
Zip
21133
Phone Number
410-655-7655
Fax Number
410-655-3941
person
Provider Business Mailing Address Details
Address
3525 Resource Drive Room C47
City
State
Zip
21133
Phone Number
410-655-7655
Fax Number
410-655-3941
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
LC1921 (Maryland)
Definition
Definition to come...
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