Provider Demographics
NPI:1487134060
Name:CAVE, ELLERY DILLON SR (PASTORAL COUNSELOR)
Entity type:Individual
Prefix:MR
First Name:ELLERY
Middle Name:DILLON
Last Name:CAVE
Suffix:SR
Gender:M
Credentials:PASTORAL COUNSELOR
Other - Prefix:DR
Other - First Name:ELLERY
Other - Middle Name:DILLON
Other - Last Name:CAVE
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:PASTORAL COUNSELOP
Mailing Address - Street 1:1515 E SILVER SPRINGS BLVD STE 1183
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-6832
Mailing Address - Country:US
Mailing Address - Phone:352-445-6690
Mailing Address - Fax:
Practice Address - Street 1:1515 E SILVER SPRINGS BLVD STE 1183
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6832
Practice Address - Country:US
Practice Address - Phone:352-445-6690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty