Provider Demographics
NPI:1134451768
Name:ELLIS, LOUIS N (MSW, LISW)
Entity type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:N
Last Name:ELLIS
Suffix:
Gender:M
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:CHAIM
Other - Middle Name:N
Other - Last Name:ELLIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3495 BAINBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2237
Mailing Address - Country:US
Mailing Address - Phone:216-321-0781
Mailing Address - Fax:
Practice Address - Street 1:27600 CHAGRIN BLVD STE 140
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:OH
Practice Address - Zip Code:44122-4498
Practice Address - Country:US
Practice Address - Phone:216-450-1300
Practice Address - Fax:216-450-1252
Is Sole Proprietor?:No
Enumeration Date:2010-02-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.16006241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical