Provider Demographics
NPI:1295156453
Name:ELLISON, ANGELA KAY (MA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:KAY
Last Name:ELLISON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 C HERMAN AVE. EXT.
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803
Mailing Address - Country:US
Mailing Address - Phone:828-684-7729
Mailing Address - Fax:828-684-7729
Practice Address - Street 1:8 C HERMAN AVE. EXT.
Practice Address - Street 2:FINE PSYCHOLOGICAL ASSOCIATES, P.A.
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803
Practice Address - Country:US
Practice Address - Phone:828-684-7729
Practice Address - Fax:828-684-7729
Is Sole Proprietor?:No
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1186101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health