Provider Demographics
NPI:1609888718
Name:DROWNS, ELLEN (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:ELLEN
Middle Name:
Last Name:DROWNS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7704 SAINT CLAIR HWY
Mailing Address - Street 2:
Mailing Address - City:CASCO
Mailing Address - State:MI
Mailing Address - Zip Code:48064-1522
Mailing Address - Country:US
Mailing Address - Phone:810-326-0647
Mailing Address - Fax:
Practice Address - Street 1:2875 HENRY ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-2526
Practice Address - Country:US
Practice Address - Phone:810-987-9700
Practice Address - Fax:810-987-9148
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010655001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIM97240018Medicare ID - Type Unspecified