Individual provider · Type 1 NPI

Larry D. Ellis

Mental Health Counselor · Corinth, MS

NPI number 1124499405 Active

Practice location

2664 S Harper Rd
Corinth, MS 38834-6723

Mailing address

20 Deer Trail Rd
Selmer, TN 38375-6695

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1124499405

Larry D. Ellis's National Provider Identifier is 1124499405, issued on Oct 13, 2015. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Corinth, MS. The record was last updated on Oct 13, 2015.