Provider Demographics
NPI:1093352379
Name:ELLING, ALISON MCKENSIE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:MCKENSIE
Last Name:ELLING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 E 3RD ST STE 120
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3234
Mailing Address - Country:US
Mailing Address - Phone:980-443-7328
Mailing Address - Fax:
Practice Address - Street 1:1850 E 3RD ST STE 120
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3234
Practice Address - Country:US
Practice Address - Phone:980-443-7328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW162661041C0700X
NCC0126491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical