Octavia Ellison, CRC, CTRS
NPI 1073180808ActiveIndividual· Recreation Therapist· Lake City, FL
Recreation Therapist (CRC, CTRS) in Lake City, Florida, with an NPI issued in June 2021.
Overview
| NPI | 1073180808 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CRC, CTRS |
| Sole proprietor | No |
| NPI issued | Jun 9, 2021 |
| Last updated in NPPES | Jun 9, 2021 |
| Certified by provider | Jun 9, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Recreation Therapist Primary | 225800000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Recreation Therapist providers in Lake City
- 1922685734
- 1851091151
- 1174498331
- 1730584418