Provider Demographics
NPI:1669639753
Name:ELLENBECKER AND BORSELLINO PLLC
Entity Type:Organization
Organization Name:ELLENBECKER AND BORSELLINO PLLC
Other - Org Name:TALK TO ME SPEECH THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:ELLENBECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-596-1830
Mailing Address - Street 1:4894 W LONE MOUNTAIN RD # 176
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2239
Mailing Address - Country:US
Mailing Address - Phone:702-203-7504
Mailing Address - Fax:702-201-1431
Practice Address - Street 1:513 SALT LICK TRL
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-3321
Practice Address - Country:US
Practice Address - Phone:702-203-7504
Practice Address - Fax:702-201-1431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
NV235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1457518417Medicaid