Ewart Ellsworth, Brean Rae

Ewart Ellsworth, Brean Rae is an individual health care provider with primary practice located at 1152 Wood St , California PA 15419-1260. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Ewart Ellsworth, Brean Rae can be contacted via phone (724) 938-2099.

Contact Information

Primary practice address
1152 Wood St California PA 15419-1260
Phone: (724) 938-2099
Fax: (724) 938-3221
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1053395541
LBN Legal business name Ewart Ellsworth, Brean Rae
Credentials Bachelor of Arts (BA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Apr 17th, 2008 - about 17 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 1053395541 NPPES
Pennsylvania Other 328834D024298 VALUE BEHAVIORAL HEALTH
Pennsylvania MEDICAID 1007288440098 VALUE BEHAVIORAL HEALTH

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