Provider Demographics
NPI:1265930069
Name:ELLINGTON, ALMA J (LAPC)
Entity type:Individual
Prefix:
First Name:ALMA
Middle Name:J
Last Name:ELLINGTON
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:ALMA
Other - Middle Name:J
Other - Last Name:ELLINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAPC
Mailing Address - Street 1:306 N DAVIS DR STE B
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-3476
Mailing Address - Country:US
Mailing Address - Phone:478-319-2907
Mailing Address - Fax:
Practice Address - Street 1:306 NORTH DAVIS DRIVE
Practice Address - Street 2:SUITE B ROOM 4
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093
Practice Address - Country:US
Practice Address - Phone:478-319-2907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC003920101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health