Provider Demographics
NPI:1821401746
Name:ELLERMEYER, JAMES W III (LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:W
Last Name:ELLERMEYER
Suffix:III
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 PENN CENTER BLVD
Mailing Address - Street 2:APT 104
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-6022
Mailing Address - Country:US
Mailing Address - Phone:724-388-2071
Mailing Address - Fax:
Practice Address - Street 1:800 PENN CENTER BLVD
Practice Address - Street 2:APT 104
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-6022
Practice Address - Country:US
Practice Address - Phone:724-388-2071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007650101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional