Individual provider · Type 1 NPI

Tyan R. Ellsworth, CADC

Addiction (Substance Use Disorder) Counselor · Atlantic, IA

NPI number 1366684722 Active

Practice location

1500 E 10th St
Atlantic, IA 50022-1935

Fax (712) 243-1337

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X95005 (IA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1366684722

Tyan R. Ellsworth, CADC's National Provider Identifier is 1366684722, issued on Apr 1, 2009. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Atlantic, IA. The record was last updated on Nov 16, 2015.