Provider Demographics
NPI:1962580563
Name:ALAIMO, ELLEN DOREEN (PMHCNS-BC)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:DOREEN
Last Name:ALAIMO
Suffix:
Gender:F
Credentials:PMHCNS-BC
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3167 FULTON RD
Mailing Address - Street 2:105
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1465
Mailing Address - Country:US
Mailing Address - Phone:216-283-4400
Mailing Address - Fax:216-281-7194
Practice Address - Street 1:3167 FULTON RD
Practice Address - Street 2:105
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1465
Practice Address - Country:US
Practice Address - Phone:216-283-4400
Practice Address - Fax:216-281-7194
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN234364364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP92295Medicare UPIN