Ellis, Kelly A
Ellis, Kelly A is an sole proprietor health care provider with primary practice located at 39760 Black Mesa Ln , Palm Desert CA 92260. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ellis, Kelly A can be contacted via phone (760) 832-4904.Contact Information
Primary practice address
39760 Black Mesa Ln
Palm Desert CA 92260
Phone: (760) 832-4904
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LCS 16686 | California |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CSW.0992416 | Colorado |
Profile Details
| NPI number | 1073548186 |
|---|---|
| LBN Legal business name | Ellis, Kelly A |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Aug 1st, 2023 - about last year |
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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