RAVEN KETURAH ELLIS LCPC
NPI 1003909664
Counselor - Professional in Randallstown, MD

Active since October 02, 2006
3525 RESOURCE DRIVE ROOM C47, RANDALLSTOWN, MD 21133(410) 655-7655(410) 655-3941 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Raven Keturah Ellis Lcpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAVEN KETURAH ELLIS LCPC (NPI 1003909664) is an individual professional provider in Randallstown, Maryland, licensed in Maryland (LC1921) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1003909664
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameRAVEN KETURAH ELLISCredential: LCPC
Location Address3525 RESOURCE DRIVE ROOM C47Randallstown, MD 21133
Mailing Address10400 Ridgeland Road Ste 1Cockeysville, MD 21030 · (410) 628-6120 · Fax (410) 628-9825
Fax(410) 655-3941
Sole ProprietorNo
Enumeration DateOctober 2, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1003909664 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in MD · LC1921
3525 RESOURCE DRIVE ROOM C47, Randallstown, MD 21133

Other Names 1

Other Name (5)Raven Keturah Ellis-taylor

Other Identifiers 3

OtherR5830050Carefirst Ehmsi
Other251690Compsych
Other64558301Carefirst Md

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Addiction (Substance Use Disorder))
3525 RESOURCE DRIVE ROOM C47
RANDALLSTOWN, MD 21133
Social Worker (Clinical)
3525 RESOURCE DRIVE ROOM C47
RANDALLSTOWN, MD 21133

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raven Ellis's NPI number?

The NPI number for Raven Ellis is 1003909664. It was assigned to this individual provider in the NPPES registry on October 2, 2006. The provider is also known as Raven Keturah Ellis-Taylor.

Where is Raven Ellis located?

Raven Ellis practices at 3525 Resource Drive Room C47, Randallstown, MD 21133. The listed phone number is (410) 655-7655.

What is Raven Ellis's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Raven Ellis was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.