Provider Demographics
NPI:1710085683
Name:ARLEDGE, ELLEN (MSW)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:
Last Name:ARLEDGE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3635 MANASSAS DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4031
Mailing Address - Country:US
Mailing Address - Phone:540-774-4686
Mailing Address - Fax:
Practice Address - Street 1:3635 MANASSAS DR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4031
Practice Address - Country:US
Practice Address - Phone:540-774-4686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040023411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical