Provider Demographics
NPI:1417330358
Name:ELWELL, CHAREL
Entity Type:Individual
Prefix:
First Name:CHAREL
Middle Name:
Last Name:ELWELL
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 1:530 CAPITOL HILL AVE
Mailing Address - Street 2:APT. C
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3062
Mailing Address - Country:US
Mailing Address - Phone:775-351-7585
Mailing Address - Fax:
Practice Address - Street 1:530 CAPITOL HILL AVE
Practice Address - Street 2:APT. C
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3062
Practice Address - Country:US
Practice Address - Phone:775-351-7585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health