Provider Demographics
NPI:1740339845
Name:ELLEN KUBAY ADKINS
Entity type:Organization
Organization Name:ELLEN KUBAY ADKINS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:KUBAY
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-433-4430
Mailing Address - Street 1:77 W ELMWOOD DR
Mailing Address - Street 2:116
Mailing Address - City:CENTERVILLE FINANCE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4239
Mailing Address - Country:US
Mailing Address - Phone:937-433-4430
Mailing Address - Fax:
Practice Address - Street 1:77 W ELMWOOD DR
Practice Address - Street 2:116
Practice Address - City:CENTERVILLE FINANCE
Practice Address - State:OH
Practice Address - Zip Code:45459-4239
Practice Address - Country:US
Practice Address - Phone:937-433-4430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty