Provider Demographics
NPI:1902604762
Name:CHENAULT, ELLEN
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:CHENAULT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 SPRING MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON BORO
Mailing Address - State:PA
Mailing Address - Zip Code:17582-9735
Mailing Address - Country:US
Mailing Address - Phone:717-951-4190
Mailing Address - Fax:
Practice Address - Street 1:2575 EASTERN BLVD STE 108
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2903
Practice Address - Country:US
Practice Address - Phone:717-978-0538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL003664L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist