Provider Demographics
NPI:1023844602
Name:ALSTON, ELLA MAY (BS)
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:MAY
Last Name:ALSTON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WARE DR
Mailing Address - Street 2:
Mailing Address - City:BALDWINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01436-1358
Mailing Address - Country:US
Mailing Address - Phone:603-219-6601
Mailing Address - Fax:
Practice Address - Street 1:205 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-2781
Practice Address - Country:US
Practice Address - Phone:978-488-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health