| Doctor Name: | ELLEN M SEVERSON |
| NPI Number: | 1295883387 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSSA, LISW |
| License Number: | I0009998 |
| Business Practice Address: | 402 Sandhurst Dr Highland Heights, OH - 441433604 |
| Business Phone Number: | 2162010339 |
| Business Fax Number: | |
| Mailing Address: | 23725 Wolf Rd, BAY VILLAGE |
| State: | OH |
| Postal Code: | 441402854 |
| Phone Number: | 2168496165 |
| Fax Number: | 4404714948 |
| NPI Enumeration Date: | 01/08/2007 |
| NPI Last Update Date: | 01/31/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I0009998 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |