Provider Demographics
NPI:1326748641
Name:ELLYN NITCHALS-KELLNER LMHC LLC
Entity Type:Organization
Organization Name:ELLYN NITCHALS-KELLNER LMHC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:NITCHALS-KELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:515-815-6466
Mailing Address - Street 1:511 DUFF AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-6391
Mailing Address - Country:US
Mailing Address - Phone:515-815-6466
Mailing Address - Fax:515-619-6207
Practice Address - Street 1:511 DUFF AVE STE 301
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6391
Practice Address - Country:US
Practice Address - Phone:515-815-6466
Practice Address - Fax:515-619-6207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty