Provider Demographics
NPI:1902261472
Name:JAMES, ELLEN PATRICIA-ANN
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:PATRICIA-ANN
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 SPRING HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-1822
Mailing Address - Country:US
Mailing Address - Phone:251-287-8454
Mailing Address - Fax:251-287-8477
Practice Address - Street 1:2900 SPRING HILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-1822
Practice Address - Country:US
Practice Address - Phone:251-287-8454
Practice Address - Fax:251-287-8477
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1685 G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1685 GOtherLICENSED GRADUATE LEVEL SOCIAL WORKER