Individual provider · Type 1 NPI

Steven Mark Ellsworth, LADC/MH

Mental Health Counselor · Edmond, OK

NPI number 1194562264 Active

Practice location

800 Myrtle Dr
Edmond, OK 73034-4639

Call (405) 517-7243 Map

Mailing address

PO Box 2468
Edmond, OK 73083-2468

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X1367 (OK)

Mental Health Counselor: Definition to come...

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About NPI 1194562264

Steven Mark Ellsworth, LADC/MH's National Provider Identifier is 1194562264, issued on Jul 15, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Edmond, OK. The record was last updated on Jul 15, 2024.