Individual provider · Type 1 NPI

Michael Ethen Ellison

Mental Health Counselor · Santa Rosa, CA

NPI number 1316657349 Active

Practice location

2300 Northpoint Pkwy
Santa Rosa, CA 95407-5004

Call (707) 571-8452 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1316657349

Michael Ethen Ellison's National Provider Identifier is 1316657349, issued on Nov 30, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Santa Rosa, CA. The record was last updated on Nov 30, 2022.