Individual provider · Type 1 NPI

Ellisen Herndon

Mental Health Counselor · Atlanta, GA

NPI number 1154110559 Active

Practice location

250 Georgia Ave SE Ste 206
Atlanta, GA 30312-3000

Specialties and licenses

TaxonomyCodeLicense
Community Health Worker 172V00000XNone listed
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1154110559

Ellisen Herndon's National Provider Identifier is 1154110559, issued on May 2, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Atlanta, GA. The record was last updated on May 2, 2025.