Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Octavia Ellison, CRC, CTRS

Individual provider Recreation Therapist · NPI 1073180808

Octavia Ellison, CRC, CTRS is a Recreation Therapist in Lake City, Florida. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

619 S Marion Ave
Lake City, FL 32025-5808
Phone: (386) 755-3016
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Recreation Therapist (primary) Taxonomy 225800000X

Record details

NPI number1073180808
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRC , CTRS
Sole proprietorNo
NPI enumeratedJune 9, 2021
Last updated in NPPESJune 9, 2021
Certification dateJune 9, 2021

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