Raven Keturah Ellis
Professional Counselor
3525 Resource Drive Room C47
Randallstown
, Maryland 21133
Raven Keturah Ellis
Professional Counselor
3525 Resource Drive Room C47
Randallstown
, Maryland 21133
(410) 628-9825
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About
Features
Specialties
- Professional Counselor
Languages spoken
- English
Location
First Address
- Raven Keturah Ellis
- 10400 Ridgeland Road Ste 1
- Cockeysville, MD
- Zip : 21030
- Fax : (410) 628-9825
- Phone : (410) 628-6120
Second Address
- Raven Keturah Ellis
- 3525 Resource Drive Room C47
- Randallstown, MD
- Zip : 21133
- Fax : (410) 655-3941
- Phone : (410) 655-7655
Reviews
FAQs
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Is Raven Keturah Ellis accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 101YP2500X | Professional Counselor | LC1921 | MD |
National Provider Identifier
| NPI | 1003909664 |
|---|---|
| Provider Name | Raven Keturah Ellis |
| First Address | Cockeysville, MD 21030 |
| Second Address | Randallstown, MD 21133 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/10/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 251690 | COMPSYCH (01) | |
| 64558301 | CAREFIRST MD (01) | |
| R5830050 | CAREFIRST EHMSI (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.