Provider Demographics
NPI:1457542235
Name:LABELLE, ELLEN JONES (MD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:JONES
Last Name:LABELLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3514 DUFF DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-1415
Mailing Address - Country:US
Mailing Address - Phone:301-529-9190
Mailing Address - Fax:703-379-9645
Practice Address - Street 1:3514 DUFF DR
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-1415
Practice Address - Country:US
Practice Address - Phone:301-529-9190
Practice Address - Fax:703-379-9645
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG412082084P0800X
VA01010294572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA92240Medicare UPIN