Provider Demographics
NPI:1710134549
Name:SALMON, ELLEN TERRY (BS, MA, LPC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:TERRY
Last Name:SALMON
Suffix:
Gender:F
Credentials:BS, MA, LPC
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:S
Other - Last Name:SALMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS, MA, LPC
Mailing Address - Street 1:PO BOX 638
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-0012
Mailing Address - Country:US
Mailing Address - Phone:214-662-1778
Mailing Address - Fax:
Practice Address - Street 1:705 N GREENVILLE AVE
Practice Address - Street 2:STE.716
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-2167
Practice Address - Country:US
Practice Address - Phone:972-727-9739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20194101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional