Carpenter, H. Ellis

Carpenter, H. Ellis is an sole proprietor health care provider with primary practice located at 300 Medical Dr Suite 705 Ellis Carpenter, Lmft, Lagrange GA 30240-4155. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Carpenter, H. Ellis can be contacted via phone (706) 885-0111.

Contact Information

Primary practice address
300 Medical Dr Suite 705 Ellis Carpenter, Lmft Lagrange GA 30240-4155
Phone: (706) 885-0111
Fax: (706) 885-0607
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 710 Georgia

Profile Details

NPI number 1831155829
LBN Legal business name Carpenter, H. Ellis
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 26th, 2006
Last updated May 16th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831155829 NPPES
Georgia MEDICAID 793918807A

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