Green, Cornelia Ellis
Green, Cornelia Ellis is an sole proprietor health care provider with primary practice located at 419 Pleasant St Suite 313, Beloit WI 53511-6249. She recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as her primary health care specialty. Green, Cornelia Ellis can be contacted via phone (608) 365-7078.Contact Information
Primary practice address
419 Pleasant St Suite 313
Beloit WI 53511-6249
Phone: (608) 365-7078
Fax: (608) 365-7464
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | 951-057 | Wisconsin |
Profile Details
| NPI number | 1023162468 |
|---|---|
| LBN Legal business name | Green, Cornelia Ellis |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 23rd, 2007 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023162468 | NPPES |
| Wisconsin | MEDICAID | 39027300 |
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