Provider Demographics
NPI:1790098358
Name:ELLINGTON, LAURA BEECH (MSW, PLCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:BEECH
Last Name:ELLINGTON
Suffix:
Gender:F
Credentials:MSW, PLCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N SECOND ST
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-2401
Mailing Address - Country:US
Mailing Address - Phone:336-265-7298
Mailing Address - Fax:919-304-9546
Practice Address - Street 1:503 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4118
Practice Address - Country:US
Practice Address - Phone:919-718-9339
Practice Address - Fax:919-776-9432
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0059301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical