Ellis, James Stephen

Ellis, James Stephen is an individual health care provider with primary practice located at 1701 White St , Mccomb MS 39648-2711. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Ellis, James Stephen can be contacted via phone (601) 684-2173.

Contact Information

Primary practice address
1701 White St Mccomb MS 39648-2711
Phone: (601) 684-2173
Fax: (601) 249-4234
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 30428 Mississippi

Profile Details

NPI number 1437183308
LBN Legal business name Ellis, James Stephen
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Jul 8th, 2007 - 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 1437183308 NPPES
Mississippi MEDICAID 0124731

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